Natural Course Following Pediatric Tracheostomy

Abstract

Chronic lung disease, subglottic stenosis, and combinations are the most common causes for tracheostomy at present followed for tracheostomy due to neurological problems. Children requiring tracheostomy have lengthy hospital stay. Establishing an accurate diagnosis helps predict the length of hospitalization and the need for home ventilation; however, in less clear cases, the length of stay can be predicted from the presence of pulmonary hypertension, reflux, and failure to thrive. The mortality rate is low at the postoperative period and increases depending upon the underline reason for tracheostomy referral.

Critical Care for Rare Diseases (and Procedures)

“…In (3) which is similar to other reported rates (4,5). The authors conclude, "…that early tracheostomy may have benefits without adversely affecting mortality."…”

Retrospective, cross-sectional review of delayed discharge after paediatric tracheostomy

“…9 Spentzas et al also commented on a number of social factors, including single parenting, which they felt may interfere with caregiver training prior to discharge. 10 In our cohort, a number of parents separated whilst the child was in hospital. Having a child in hospital long-term can be stressful on relationships, particularly if there are other siblings to care for and long distances to travel.…”

Rehabilitation Considerations for Children Dependent on Long-Term Mechanical Ventilation

“…Short-term invasive ventilation is delivered via endotracheal tube and may be used postsurgery, postinjury, following premature birth with underdeveloped lungs, and for acute respiratory failure due to illness [25]. For long-term MV, an endotracheal tube is no longer reasonable but rather a tracheostomy is required [28,29]. A tracheostomy is a surgically placed plastic or silicone tube placed between the third and fourth tracheal rings in the tracheal stoma to which the ventilator tubing is attached [28].…”

“…A tracheostomy is a surgically placed plastic or silicone tube placed between the third and fourth tracheal rings in the tracheal stoma to which the ventilator tubing is attached [28]. The size and shape of the tube are chosen based on the child's age, lung mechanics and upper airway resistance and speech needs [28][29][30]. In contrast, noninvasive positive pressure ventilation (NPPV) is delivered through an alternative interface such as a face mask or nasal prongs, and can be used short-or long-term [25].…”