Pediatric tracheostomies: A recent experience from one academic center*

Abstract

Children with tracheostomies are a heterogeneous population. Children who require tracheostomy for long-term mechanical ventilation have longer hospital stays than children who receive a tracheotomy on an elective or emergent basis. Hospital readmissions should be anticipated in this complex group of patients.

A Multidisciplinary Children’s Airway Center: Impact on the Care of Patients With Tracheostomy

“…14,[18][19][20][21] The initiative to improve communication resulted in implementation of weekly clinical care conferences focused on treatment planning, with video review and discussion of airway pathology contributing an educational component. Efforts to avoid tracheostomy complications led to applying a consensus-driven algorithm to the decannulation process increasing the likelihood of successful decannulation by 18%, and aligning institutional standards with nationally recognized recommendations for interval airway surveillance examinations of 6 to 12 months.…”

The Chronically Critically Ill Patient: Pediatric Considerations

“…It should be noted that tracheostomy placement in the pediatric population is common, with approximately 5,000 procedures annually in the United States. 28 Graf et al 4 found that the most common reasons for tracheostomy placement in the pediatric population are airway management (63%), chronic respiratory disease (23%), central hypoventilation (9%), and neuromuscular weakness (6%). Other general indications include chronic respiratory disease, central hypoventilation syndrome, and neuromuscular weakness in descending order of occurrence.…”

“…Special consideration must be given to the relatively large subset of pediatric patients with congenital heart disease, which comprises an important group of pediatric patients with chronic, critical illness. 4 Nutritionally, infants and children, especially those with chronic illness, generally have much lower nutritional reserve than their adult counterparts. Lastly, it must be noted that the majority of chronically critically ill pediatric patients have comorbidities, many of which are congenital-metabolic, respiratory, central nervous system, and/or cardiac-in origin.…”

Consenso sobre el cuidado del niño con traqueostomía

“…En las últimas déca-das, como contracara de los avances en los cuidados críticos pediátricos y neonatales, el número de niños que ha requerido una traqueostomía se ha incrementado. [6][7][8][9][10][11][12][13][14] Sin embargo, existen pocas publicaciones que respalden con evidencia fuerte las recomendaciones sobre su cuidado en la población infantil y ningún consenso publicado sobre su cuidado a nivel nacional.…”