The changing indications for paediatric tracheostomy

Hadfield, P. J.; Lloyd-Faulconbridge, Ruth V.; Almeyda, J; Albert, David; Bailey, C. M.

doi:10.1016/s0165-5876(02)00282-3

Cited by 83 publications

(90 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Over recent years, numerous studies in different countries have reported the individual experience of various hospitals, with the number of patients varying from 36 to 362 over periods of time ranging from 2 to 37 yrs [3,5,6,8,9,[16][17][18]. Review of these reports reveals differences between the various centres.…”

Section: Discussionmentioning

confidence: 99%

“…Later, the wide use of vaccination programmes, mainly against Corynebacterium diphtheriae and Haemophilus influenzae, together with the development of new anaesthetic materials and techniques to stabilise the upper airway, spectacularly reduced the number of emergent procedures in most series [1][2][3][4]. Nevertheless, despite these advances, the incidence of tracheostomy in children has not fallen; indeed, it has even risen in some hospitals [5][6][7][8]. This has been attributed to increased survival of assisted patients in paediatric and neonatal intensive care units (ICUs), with the progressive appearance of what has been termed the ''technology-dependent paediatric patient'' [9], referring mainly to children on long-term assisted ventilation, or with congenital or acquired upper airway anomalies.…”

mentioning

confidence: 99%

“…This has been attributed to increased survival of assisted patients in paediatric and neonatal intensive care units (ICUs), with the progressive appearance of what has been termed the ''technology-dependent paediatric patient'' [9], referring mainly to children on long-term assisted ventilation, or with congenital or acquired upper airway anomalies. This notable change in the indications for tracheostomy has transformed the technique into a programmed, long-term, elective procedure, just the opposite to its original indications as an emergency procedure [2,5,10].…”

mentioning

confidence: 99%

See 2 more Smart Citations

Paediatric patients with a tracheostomy: a multicentre epidemiological study

Pérez-Ruíz¹,

Caro²,

Pérez‐Frías³

et al. 2012

Eur Respir J

View full text Add to dashboard Cite

Changes in the indications for tracheostomy in children have led to the progressively greater involvement of the paediatric pulmonologist in the care of these patients. The aim of this study was to review the current profile of tracheostomised children in Spain.We undertook a longitudinal, multicentre study over 2 yrs (2008 and 2009) of all patients aged between 1 day and 18 yrs who had a tracheostomy.The study, involving 18 Spanish hospitals, included 249 patients, of whom 150 (60.2%) were ,1 yr of age. The main indications for the procedure were prolonged ventilation (n5156, 62.6%), acquired subglottic stenosis (n534, 13.6%), congenital or acquired craniofacial anomalies (n525, 10%) and congenital airway anomalies (n524, 9.6%). The most frequent underlying disorders were neurological diseases (n5126, 50.6%) and respiratory diseases (n598, 39.3%). Over the 2-yr study period, 92 (36.9%) children required ventilatory support, and decannulation was achieved in 59 (23.7%). Complications arose in 117 patients (46.9%). Mortality attributed to the underlying condition was 12.5% and that related directly to the tracheostomy was 3.2%.Respiratory complexity of tracheostomised children necessitates prolonged, multidisciplinary follow-up, which can often extend to adulthood.

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Paediatric patients with a tracheostomy: a multicentre epidemiological study

Pérez-Ruíz¹,

Caro²,

Pérez‐Frías³

et al. 2012

Eur Respir J

View full text Add to dashboard Cite

show abstract

“…Currently, the most common indication for pediatric tracheostomy is prolonged intubation; 5,18,19 followed by intubation for tracheobronchial hygiene and congenital malformations of the airway. 5 Children requiring mechanical ventilation are initially managed using tracheal intubation, with the indication of tracheostomy depending on the subjacent disease and the age of the child.…”

Section: Indicationsmentioning

confidence: 99%

“…3 The incidence of acute tracheostomy complications varies from 5 to 49% 10,15,25,27-30 and includes bleeding, pneumothorax, pneumomediastinum, emphysema subcutaneous, accidental decannulation, obstructed cannulae, tracheal laceration, tracheoesophageal fistula, infection of the surgical wound and cervical abscess. Later complications are described in 24 to 100% of children 10,19,25,[27][28][29][30] and include granulation tissue, bleeding, infection, pneumothorax, tracheal stenosis, tracheomalacia, fusion of the vocal cords and tracheoesophageal fistula.…”

Section: Complicationsmentioning

confidence: 99%

Traqueostomia na criança

Fraga¹,

Souza²,

Kruel³

2009

J. Pediatr. (Rio J.)

View full text Add to dashboard Cite

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.

show abstract

Pediatric tracheotomy: Indications and decannulation outcomes

et al. 2014

View full text Add to dashboard Cite

Objective The objective of this study was to determine if there are differences in decannulation rates and duration of cannulation between pediatric patients undergoing tracheotomy for different indications. Study Design Retrospective chart review. Methods Medical records for pediatric patients (age 0–18 years) undergoing tracheotomy between January 1, 2003 and May 31, 2012 were retrospectively reviewed. Patients were assigned an indication for tracheotomy from five categories: neurological, cardiopulmonary, upper airway obstruction, craniofacial anomalies, and maxillofacial/laryngotracheal trauma. Results Initial chart review identified 124 patients, 113 for whom complete data was available. Of these patients, the indications for tracheotomy were cardiopulmonary disease in 24 (21.2%), craniofacial anomalies in 12 (10.6%), neurological impairment in 44 (38.9%), traumatic injury in 11 (9.7%), and upper airway obstruction in 22 (19.5%). The time to decannulation was shorter for trauma patients compared to cardiopulmonary (P = 0.044) and neurological patients (P = 0.001). A total of 32 (31.9%) patients were decannulated during the study period, with a higher rate in trauma patients (72.7%) and a lower rate in those with upper airway obstruction (36.4%) than would be expected under homogeneity. Of the 32 patients who were decannulated, 11 (30.6%) were decannulated during the same hospitalization in which the tracheotomy was performed. Conclusion This study demonstrates a difference in overall decannulation rates and a shorter time to decannulation in children undergoing tracheotomy for maxillofacial and laryngotracheal trauma compared to cardiopulmonary and neurological indications.

show abstract

The changing indications for paediatric tracheostomy

Cited by 83 publications

References 13 publications

Paediatric patients with a tracheostomy: a multicentre epidemiological study

Paediatric patients with a tracheostomy: a multicentre epidemiological study

Traqueostomia na criança

Pediatric tracheotomy: Indications and decannulation outcomes

Contact Info

Product

Resources

About