Long-Term Outcomes After Pediatric Tracheostomy—Candidates for and Timing of Decannulation

Sekioka, Akinori; Fukumoto, Koji; Nakaya, Kengo; Nomura, Akiyoshi; Yamada, S.; Kanai, Risa; Urushihara, Naoto

doi:10.1016/j.jss.2020.05.061

Cited by 8 publications

(5 citation statements)

References 20 publications

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“…For many patients with severe or irreversible brain injury or malformation, the discussion about a tracheostomy is a mandatory part of care, and a successful decannulation cannot realistically be expected in most cases. 72 Although it was not an objective of the study's revision, the authors observed in the literature that the indication of tracheostomy in children has changed from an emergency procedure during diphtheria and poliomyelitis epidemics to support for children with chronic conditions and dependent on assisted ventilation. 73 Higher rates of tracheostomy for weaning from ventilation are reported from quaternary referral centers in developed countries, 74 whereas, in a mid-incoming country like Brazil, the most common indications are obstructive airway conditions.…”

Section: Discussionmentioning

confidence: 99%

Tracheostomy practices in children on mechanical ventilation: a systematic review and meta-analysis

Araújo

Azevedo

Oliveira

et al. 2022

Jornal de Pediatria

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Section: Discussionmentioning

confidence: 99%

Tracheostomy practices in children on mechanical ventilation: a systematic review and meta-analysis

Araújo

Azevedo

Oliveira

et al. 2022

Jornal de Pediatria

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“…In the literature, the overall mortality rate of children with tracheostomies ranges from 2.9% to 59.0%, whereas tracheostomy‐related mortality rates range from 0% to 5.9% 3,4,20 . In our study, the mortality rate was 16%, likely because most children in our cohort had NMD.…”

Section: Discussionmentioning

confidence: 62%

“…In the literature, the overall mortality rate of children with tracheostomies ranges from 2.9% to 59.0%, whereas tracheostomyrelated mortality rates range from 0% to 5.9%. 3,4,20 In our study, the mortality rate was 16%, likely because most children in our cohort had NMD. None of the deaths in our study were directly related to tracheostomy, but we can say that the sample size was too small to draw a definitive conclusion on this issue.…”

Section: Evaluation Of Respiratory Culturesmentioning

confidence: 59%

Long‐term outcomes of standardized training for caregivers of children with tracheostomies: The IStanbul PAediatric Tracheostomy (ISPAT) project

Bilgin,

Unal,

Yanaz

et al. 2023

Pediatric Pulmonology

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Background and ObjectivesChildren with tracheostomies are at increased risk of tracheostomy‐related complications and require extra care. Standardized training programs for caregivers can improve tracheostomy care and reduce complications. In this study, we compared caregiver knowledge and skill scores after a standardized theoretical and practical training program on tracheostomy care (IStanbul PAediatric Tracheostomy (ISPAT) project) immediately and 1 year post‐training and evaluated how this training affected the children's clinical outcomes.Materials and MethodsWe included 32 caregivers (31 children) who had received standardized training a year ago and administered the same theoretical and practical tests 1 year after training completion. We recorded tracheostomy‐related complications and the number and reasons for admission to the healthcare centers. All data just before the training and 1 year after training completion were compared.ResultsAfter 1 year of training completion, the median number of correct answers on the theoretical test increased to 16.5 from 12 at pretest (p < 0.001). Compared with pretest, at 1‐year post‐training practical skills assessment scores, including cannula exchange and aspiration, were significantly higher (both p < 0.001) and mucus plug, bleeding, and stoma infection reduced significantly (p = 0.002, 0.022, and 0.004, respectively). Hands‐on‐training scores were better than pretest but declined slightly at 1 year compared to testing immediately after training. Emergency admission decreased from 64.5% to 32.3% (p = 0.013). Hospitalization decreased from 61.3% to 35.5% (p = 0.039).ConclusionOur findings indicate that caregiver training can lead to a persistent increase in knowledge and skill for as long as 1 year, as well as improvements in several measurable outcomes, although a slight decrease in scores warrants annual repetitions of the training program.

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“…Although this rate was slightly higher than reported in the literature, it was necessary as 45.4% of the patients were afflicted with a neurometabolic disease and 27.2% suffered from malignancy. The requirement for long-term follow-up is further supported by the associated increased risk of mortality as noted in the study by Sekioka et al 14 in which children with a tracheostomy due to neurometabolic disease had an exceptionally high mortality rate of 46%. Therefore, attention to caregiver health is necessary to ensure the long-term follow-up and to reduce the associated risk of mortality for those children who require a tracheostomy.…”

Section: Discussionmentioning

confidence: 97%

Factors Affecting the Quality of Life of Parents Caring for Pediatric Patients with a Tracheostomy

Koker,

Tekerek,

Nalbant

et al. 2023

J Pediatr Intensive Care

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Objectives This study aimed to evaluate factors affecting the quality of life (QOL) of parents of children who underwent placement of a tracheostomy while in the pediatric intensive care unit (PICU) through postdischarge use of a standardized questionnaire, Functional Status Scale (FSS) for patients, and WHOQoL-BREF (a QOL scale) for parents. Methods The parents were initially contacted by telephone, postdischarge, during which the standardized questionnaire was completed. The functional status of the patients was evaluated using the FSS, and the QOL of parents was determined through use of the WHOQoL-BREF scale. Results From 2011 to 2021, tracheostomy was performed in 119 PICU patients. Overall, 93 patients were excluded due to death in 66 (56%), decannulation in 24 (20%) and, 3 (2%) were not available for follow-up. The parents of 26 (22%) patients were available for follow-up and for which the standardized questionnaire FSS and WHOQoL-BREF QOL scales were completed. The mean FSS score of the patients was elevated at 17.84. In comparison, reduced mean scores were observed for parental physical health of 20.61, psychological health of 20.57, social health of 11.15, and environmental health of 29.00. As a result, a moderate (r < 0.80), yet significant (p ≤ 0.004) negative correlation was found between the FSS scores of patients and the physical, social relationships, environmental, and psychological health QOL scores of parents. Conclusion This study is unique in that, to our knowledge, it is the first to compare parental QOL with the FSS of pediatric patients who have undergone a tracheostomy while hospitalized in the PICU. Our findings indicate that the parental QOL was reduced in four areas and correlates with an elevation in FSS score (indicating a greater functional disorder) of pediatric patients who had previously undergone a tracheostomy while hospitalized in the PICU.

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Long-Term Outcomes After Pediatric Tracheostomy—Candidates for and Timing of Decannulation

Cited by 8 publications

References 20 publications

Tracheostomy practices in children on mechanical ventilation: a systematic review and meta-analysis

Tracheostomy practices in children on mechanical ventilation: a systematic review and meta-analysis

Long‐term outcomes of standardized training for caregivers of children with tracheostomies: The IStanbul PAediatric Tracheostomy (ISPAT) project

Factors Affecting the Quality of Life of Parents Caring for Pediatric Patients with a Tracheostomy

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