The changing indications for tracheostomy in children

Swift, A. C.; Rogers, J. H.

doi:10.1017/s0022215100103627

Cited by 38 publications

(29 citation statements)

References 14 publications

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“…A partir do século XX, ocorreu aumento das indicações do procedimento, que passou a ser utilizado para tratamento ou melhora dos cuidados respirató-rios ou mesmo para prevenção de estreitamentos da via aérea 9,10 A criança que necessita de ventilação mecânica é inicialmente manejada com entubação traqueal, com a indicação de traqueostomia, dependendo da doença subjacente e da idade da criança. Recém-nascidos usualmente toleram entubação por meses, com mínimo edema ou inflamação larín-gea 5 .…”

Section: Indicaçõesunclassified

Pediatric tracheostomy

Fraga¹,

Souza²,

Kruel³

2009

J Pediatr (Rio J)

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ResumoObjetivo: Apresentar revisão atualizada sobre a traqueostomia na idade pediátrica, com ênfase nas indicações, técnica cirúrgica, complicações e manejo da traqueostomia a nível hospitalar e domiciliar. Fontes dos dados:Foram selecionados pelo site de busca médica (MEDLINE e PubMed) artigos originais e de revisão sobre traqueostomia na criança, utilizando as seguintes palavras-chave: tracheostomy, tracheotomy, children, newborn. Síntese dos dados:A indicação de traqueostomia vem mudando progressivamente. No momento, ela é mais indicada na criança em ventilação mecânica prolongada. A faixa etária mais comum do procedimento também mudou, sendo atualmente mais comumente realizada em crianças menores de 1 ano de idade. Exceto em situações de emergência, a traqueostomia deve ser realizada em unidade cirúrgica, com a criança entubada. É preconizada a incisão transversa da pele e abertura longitudinal da traqueia, sem ressecção da mesma. Embora as complicações da traqueostomia na criança não sejam incomuns, elas, na maioria das vezes, não necessitam de tratamentos sofisticados ou mesmo de intervenção cirúrgica. Embora a mortalidade possa ocorrer em até 40% das crianças traqueostomizadas, ela é diretamente relacionada à traqueostomia em apenas 0 a 6% das crianças. Conclusões:A decisão de realizar traqueostomia na criança continua complexa e dependente de vários fatores. O procedimento é seguro e com menores complicações quando realizado em hospital terciário de referência e por equipe treinada e experiente. J Pediatr (Rio J). 2009;85(2):97-103:Traqueostomia, entubação prolongada, criança, recém-nascido. AbstractObjective: 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.

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Section: Indicaçõesunclassified

Pediatric tracheostomy

Fraga¹,

Souza²,

Kruel³

2009

J Pediatr (Rio J)

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“…It was detected that most of these deaths were associated with underlying diseases (15). In our series of 17 patients, the mortality rate was found to be 35.29% and all deaths occurred due to underlying diseases after tracheotomy at the late period.…”

Section: Discussionmentioning

confidence: 57%

Pediatric Tracheotomies: A 5-Year Experience in Düzce University Medical Faculty

Ünlü

Ilhan

Ünlü

et al. 2015

Turk Arch Otorhinolaryngol

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Objective: Tracheotomy is one of the oldest surgical procedures. Pediatric tracheotomy indications have changed in recent decades. Currently, tracheotomy is performed because of prolonged intubation, upper airway obstruction, neuromuscular, and craniofacial anomalies instead of acute airway infections. This study aims to present our experience regarding indications and complications of tracheotomy in pediatric patients. Methods:We retrospectively evaluated 17 pediatric patients who underwent tracheotomy because of prolonged intubation, increased pulmonary secretions, and upper respiratory tract obstruction from June 2010 to June 2015. The patients' age, gender, tracheotomy indications, duration of intubation, complications, and actual clinical condition were recorded.Results: Tracheotomy was performed on 17 pediatric patients in our clinic. Discharged patients were followed with a 3-month routine check. Six patients (35.29%) had died because of a primary disease during follow-up, and one (5.88%) of them was a one-day-old newborn who had anomalies that were incompatible with life. In one patient, emergency tracheotomy was performed because of a tracheal trauma. None of the patients has been decannulated except one (5.88%). One (5.88%) patient had an accidental decannulation, while another had bleeding in the operation field. The total minor complication rate was 11.76%, and no major complication was observed. Two (11.76%) of the discharged patients underwent re-operation for widening of the tracheotomy stoma during their routine visit. Conclusion:Currently, tracheotomy in pediatric patients is mostly performed for prolonged intubation and upper respiratory tract obstruction for which intubation is not possible. Tracheotomy enables the discharge of these patients after training their families. Keywords

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“…5 The number of indications for the procedure increased from the twentieth century onwards and it came to be used for treatment or improvement of respiratory care or even to prevent narrowing of the airway. 9,10 The principal indications for pediatric tracheostomy can be found in Table 1. 5 While the principal indications for tracheostomy in children have remained the same over the last 20 years, countless tendencies become apparent when descriptions of case reported that the incidence of tracheostomy has reduced in relation to the number of hospital admissions, although the absolute number of tracheostomies per year has remained unaltered.…”

Section: Indicationsmentioning

confidence: 99%

“…5,15 After the first successful pediatric tracheostomy was completed in 1766, the procedure began to be carried out specifically for children with airway obstruction, to the extent that it was indicated for the management of children with diphtheria, laryngitis and laryngeal edema. 9 Tracheostomy then came to be indicated in order to facilitate aspiration of secretions from the airways of children intubated for long periods. This particular indication for the procedure was well-described in children with poliomyelitis.…”

Section: Indicationsmentioning

confidence: 99%

Traqueostomia na criança

Fraga¹,

Souza²,

Kruel³

2009

J. Pediatr. (Rio J.)

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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.

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The changing indications for tracheostomy in children

Cited by 38 publications

References 14 publications

Pediatric tracheostomy

Pediatric tracheostomy

Pediatric Tracheotomies: A 5-Year Experience in Düzce University Medical Faculty

Traqueostomia na criança

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