Management of Rare Causes of Pediatric Chronic Respiratory Failure

Shi, Jenny; Al-Shamli, Nawal; Chiang, Jackie; Amin, Reshma

doi:10.1016/j.jsmc.2020.07.002

Cited by 4 publications

(3 citation statements)

References 91 publications

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“…16 While there is some evidence of the use of low fidelity simulation in the training of health care providers both at home and in-hospital in the care of tracheostomy-dependent patients, there is a paucity of literature assessing the impact of low fidelity training on family caregiver competence. 22,23 Conversely, high fidelity simulation training as part of a tracheostomy education program for family caregivers was found to be acceptable and to increase caregiver confidence in managing tracheostomy care and related emergencies. [24][25][26] Given that low fidelity training is more widely utilized and accessible, studies examining the impact of low fidelity simulation on family caregiver competence of confidence is critically needed.…”

Section: Discussionmentioning

confidence: 97%

“…The majority of institutions are employing low fidelity simulation (13/16, 75%) as mentioned in the ATS guideline on children with chronic tracheostomy, while a minority employ high fidelity simulation (1/16, 6%) 16 . While there is some evidence of the use of low fidelity simulation in the training of health care providers both at home and in‐hospital in the care of tracheostomy‐dependent patients, there is a paucity of literature assessing the impact of low fidelity training on family caregiver competence 22,23 . Conversely, high fidelity simulation training as part of a tracheostomy education program for family caregivers was found to be acceptable and to increase caregiver confidence in managing tracheostomy care and related emergencies 24–26 .…”

Section: Discussionmentioning

confidence: 99%

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Chronic tracheostomy care of ventilator‐dependent and ‐independent children: Clinical practice patterns of pediatric respirologists in a publicly funded (Canadian) healthcare system

St‐Laurent

Zielinski

Qazi

et al. 2022

Pediatric Pulmonology

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Objectives: To describe the current clinical practice patterns of Canadian pediatric respirologists at pediatric tertiary care institutions regarding chronic tracheostomy tube care and management of home invasive ventilation. Methods: A pediatric respirologist/pediatrician with expertise in tracheostomy tube care and home ventilation was identified at each Canadian pediatric tertiary care center to complete a 59-item survey of multiple choice and short answer questions. Domains assessed included tracheostomy tube care, caregiver competency and home monitoring, speaking valves, medical management of tracheostomy complications, decannulation, and long-term follow-up. Results: The response rate was 100% (17/17) with all Canadian tertiary care pediatric centers represented and heterogeneity of practice was observed in all domains assessed. For example, though most centers employ Bivona™ (17/17) and Shiley™ (15/17) tracheostomy tubes, variability was observed around tube change, re-use, and cleaning practices. Most centers require two trained caregivers (14/17) and recommend 24/7 eyes on care and oxygen saturation monitoring. Discharge with an emergency tracheostomy kit was universal (17/17). Considerable heterogeneity was observed in the timing and use of speaking valves and speech-language assessment. Inhaled anti-pseudomonal antibiotics are employed by most centers (16/17) though the indication, agent, and protocol varied by center. Though decannulation practices varied considerably, the requirement of upper airway patency was universally required to proceed with decannulation (17/17) independent of ongoing ventilatory support requirements. Conclusion: Considerable variability in pediatric tracheostomy tube care practice exists across Canada. These results will serve as a starting point to standardize and evaluate tracheostomy tube care nationally.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Chronic tracheostomy care of ventilator‐dependent and ‐independent children: Clinical practice patterns of pediatric respirologists in a publicly funded (Canadian) healthcare system

St‐Laurent

Zielinski

Qazi

et al. 2022

Pediatric Pulmonology

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“…It is worth noting that within the populations of children discussed in this study, several are predisposed to concomitant sleep‐disordered breathing. OSA is commonly seen in patients with cerebral palsy 40 and Duchenne muscular dystrophy, 41 and central sleep apnea is described in spinal muscular atrophy 42 and myotonic dystrophy. Preoperative awareness of existing sleep‐disordered breathing may allow for intraoperative and postoperative mitigation of risk.…”

Section: Assessing Risk In Your Patientmentioning

confidence: 99%

Respiratory prehabilitation in pediatric anesthesia in children with muscular and neurologic disease

St‐Laurent

Zysman-Colman

Zielinski

2021

Pediatric Anesthesia

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Children with chronic neurologic and chest wall diseases are at increased risk of postoperative respiratory complications. These complications include acute respiratory failure, atelectasis, pneumonia, need for reintubation, and need for tracheostomy and can carry significant negative impacts on patient outcomes, including mortality, and increased healthcare resource utilization. 1 As such, careful examination of risk factors in these complex children should be initiated in order to plan appropriate preoperative and postoperative interventions that help mitigate postoperative respiratory complications. Such interventions may preoperatively include initiation of respiratory support devices such as non-invasive ventilation (NIV) and airway clearance techniques and/or a plan

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Sleep-Disordered Breathing (SDB) in Pediatric Populations

Rosen

2022

Respiratory Medicine

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Management of Rare Causes of Pediatric Chronic Respiratory Failure

Cited by 4 publications

References 91 publications

Chronic tracheostomy care of ventilator‐dependent and ‐independent children: Clinical practice patterns of pediatric respirologists in a publicly funded (Canadian) healthcare system

Chronic tracheostomy care of ventilator‐dependent and ‐independent children: Clinical practice patterns of pediatric respirologists in a publicly funded (Canadian) healthcare system

Respiratory prehabilitation in pediatric anesthesia in children with muscular and neurologic disease

Sleep-Disordered Breathing (SDB) in Pediatric Populations

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