Traqueostomia na criança

Abstract

Objective: To provide an up-to-date review of pediatric tracheostomy, primarily focusing on indications, surgical technique, complications and hospital and home care.Sources: MEDLINE and PubMed databases were searched using the following keywords: tracheostomy, tracheotomy, children, newborn. Summary of the findings:Indications for tracheostomy in children are changing. Today the most common indication is prolonged ventilation. The age at the time of the procedure has also changed, with a peak incidence of tracheostomy in patients less than 1 year old. Except under emergency conditions, pediatric tracheostomy should be performed in the operating room with the child intubated. A horizontal skin incision with vertical tracheal incision and no tracheal resection is recommended. Although post-tracheostomy complications are not uncommon, they usually do not need special treatment or surgical procedures. Tracheostomy mortality can occur in up to 40% of pediatric cases, however the tracheostomy-related mortality rate is only 0 to 6%. Conclusions:The decision to perform a tracheostomy remains complex, and depends on several factors. The procedure is safe and with a low number of complications if carried out at a tertiary hospital by a trained and experienced team.J Pediatr (Rio J). 2009;85(2):97-103: Tracheostomy, tracheotomy, prolonged intubation, children, newborn.

Indications and outcome of pediatric tracheostomy: results from a Nigerian tertiary hospital

“…Intra and post-operative complications can be encountered with rates as high as 40% being reported [11]. A complication rate of 15.2% was recorded in our series.…”

“…In fact, it is known to be associated with more morbidity and mortality in this age group [10]. The mortality figures recorded range from 0-6% [11]. However, adhering to the basic surgical technique and the avoidance of emergency tracheostomies as much as possible reduces the incidence of morbidities and mortalities that may follow.…”

Endovascular stenting of tracheoinnominate fistula after tracheostomy in a 14-year-old boy

“…The innominate artery commonly traverses the trachea at the level of the 9th tracheal ring, but the cross can occur anywhere between the 6th and 13th tracheal rings6). A tracheostomy is performed at the level between the 2nd and 4th tracheal rings in adults and at the 3rd and 4th tracheal rings in children9). A high-located innominate artery, especially in thin and young patients is a possible risk factor for fistula formation4).…”

Pediatric Tracheotomy: A Relatively Rare Indication Limited to Pediatric Intensive Care Subjects?

“…This shift also affects the age at which the tracheotomy was performed. Most of the subjects were under the age of 1 (3,4,7,8). Among our subjects, twenty one (46.6%) subjects were under the age of 1.…”

“…In spite of its relative rarity, tracheotomy has greater morbidity and mortality rates when performed on newborn and infants (3). Despite the improvements in health care, high complication rates were noted between 22% and 77% in different series (5).…”