[Percutaneous tracheostomy under endoscopic guidance in adolescents]

Area of Science:

• Pediatric Critical Care Medicine
• Interventional Pulmonology
• Surgical Innovation

Background:

• Percutaneous tracheostomy (PT) is standard for adults requiring prolonged mechanical ventilation.
• Pediatric experience with PT, particularly the progressive dilatational technique, is limited.
• Severe head injury necessitates secure airway management in critically ill adolescents.

Observation:

• The Ciaglia Blue Rhino percutaneous tracheostomy method was employed in three adolescents with severe head injuries.
• Procedures were performed bedside by pediatric intensive care unit staff, utilizing fiberoptic bronchoscopic guidance.
• Hemodynamic and respiratory stability were maintained throughout all interventions.

Findings:

• No procedural complications were observed in any of the three adolescent patients.
• Two patients were successfully decannulated without any adverse events post-procedure.
• The progressive dilatational percutaneous tracheostomy demonstrated a safe and effective profile in this adolescent cohort.

Implications:

• Percutaneous tracheostomy, using the progressive dilatational method, can be safely implemented in critically ill adolescents.
• This technique offers a viable alternative for airway management in pediatric intensive care settings.
• Further research may expand the use of percutaneous tracheostomy in younger pediatric populations.