Related Experiment Video

Updated: Jul 20, 2026

Guidelines for Elective Pediatric Fiberoptic Intubation
11:19

Guidelines for Elective Pediatric Fiberoptic Intubation

Published on: January 17, 2011

Indications for tracheostomy in children

Daniel Trachsel1, Jürg Hammer

  • 1Division of Paediatric Intensive Care and Pulmonology, University Children's Hospital Basel, Römergasse 8, CH-4059 Basel, Switzerland. daniel.trachsel@ukbb.ch

Paediatric Respiratory Reviews
|August 30, 2006
PubMed

Insights

Emergency tracheostomies for acute upper airway obstruction are now rare due to medical advancements. Current indications for pediatric tracheostomy involve anticipated long-term respiratory compromise or severe airway obstruction, often requiring multidisciplinary ethical and socio-economic considerations.

Area of Science:

  • Pediatric critical care medicine
  • Otolaryngology
  • Respiratory medicine

Background:

  • Medical advancements including vaccination programs, material engineering, and anesthesia have significantly decreased emergency tracheostomies for acute upper airway obstruction.
  • Current indications for tracheostomy in children primarily involve anticipated long-term cardiorespiratory compromise from chronic ventilatory or cardiac insufficiency, or fixed, non-resolving upper airway obstruction.

Purpose of the Study:

  • To review the current indications and considerations for pediatric tracheostomy.
  • To highlight the complexities and evolving alternatives in managing pediatric airway obstruction.

Main Methods:

  • Review of current clinical practice and literature regarding pediatric tracheostomy.
  • Discussion of non-invasive ventilation and alternative devices.

Main Results:

  • Tracheostomy is now indicated for chronic conditions rather than acute emergencies.
  • Complex pediatric cases necessitate a multidisciplinary approach addressing ethical, funding, and socio-economic factors.
  • Non-invasive ventilation and devices like the in-exsufflator are emerging alternatives.

Conclusions:

  • Pediatric tracheostomy indications have shifted towards managing chronic respiratory insufficiency and severe airway obstruction.
  • A comprehensive, multidisciplinary approach is crucial for managing complex pediatric cases, considering ethical and socio-economic factors.
  • Non-invasive ventilation strategies offer promising alternatives to tracheostomy in select pediatric patients.

More Related Videos

Endotracheal Intubation via Tracheotomy and Subsequent Thoracotomy in Rats for Non-Survival Applications04:43

Endotracheal Intubation via Tracheotomy and Subsequent Thoracotomy in Rats for Non-Survival Applications

Published on: March 15, 2024

Related Concept Videos

Tracheostomy: Procedure and Tubes01:28

Tracheostomy: Procedure and Tubes

A tracheostomy is a surgical procedure that creates an artificial opening into the trachea, typically at the second or third cartilaginous ring level. This opening allows the insertion of a tracheostomy tube, which can replace an endotracheal tube, provide mechanical ventilation, bypass an upper airway obstruction, or remove accumulated tracheobronchial secretions.
Tracheostomy tubes can be made of semiflexible plastic (polyurethane or silicone), rigid plastic, or metal, and they come in...
Trachea01:22

Trachea

The trachea, commonly known as the windpipe, is a vital part of the human respiratory system. It serves as a passageway for air to travel between the larynx and the bronchi, allowing oxygen to reach the lungs. Let's explore its anatomical features, dimensions, layers of the tracheal wall, associated muscles, and the functions of its parts.
Anatomical Features:
Location: About half of the trachea is situated in the neck, anterior to the esophagus, and extends from the larynx (at the level of the...
Tracheostomy Decannulation01:21

Tracheostomy Decannulation

Tracheostomy decannulation is a significant milestone in the liberation of mechanically ventilated patients. Despite its importance, there is no universally accepted protocol for this procedure. This demands an evidence-based, individualized approach.
Description of the Procedure
Decannulation refers to the permanent removal of the tracheostomy tube, signaling the resolution of the condition that initially necessitated the tracheostomy. The process requires a well-coordinated interplay between...
Oxygen Delivering System III: Tracheostomy and T-piece01:23

Oxygen Delivering System III: Tracheostomy and T-piece

Oxygen delivery is critical in clinical care, especially for patients with respiratory disorders or those undergoing surgical procedures. Various systems, such as tracheostomy and the T-piece, deliver oxygen to the lungs, ensuring adequate arterial oxygenation.
Tracheostomy
A tracheostomy is a surgically created opening (stoma) in the anterior part of the trachea. It is used to establish a patient airway, bypass an upper airway obstruction, simplify the removal of secretions, permit long-term...
Tracheostomy Care I: Pre-procedural Steps01:16

Tracheostomy Care I: Pre-procedural Steps

A tracheostomy is a surgical technique that involves making an incision in the neck to provide access to the trachea. It is frequently used in medical conditions such as airway obstruction and prolonged mechanical ventilation. Effective nursing management is crucial for the long-term success of a tracheostomy.
Required Equipment
The equipment necessary for tracheostomy care includes:
Tracheostomy Care II: Procedure01:25

Tracheostomy Care II: Procedure

Tracheostomy care is an essential nursing skill that involves cleaning and maintaining a tracheostomy tube to prevent infection and other complications. Here's a step-by-step guide explaining each procedure with its rationale. Note that disposable gloves are to be worn at all times and changed as often as needed to maintain a sterile work environment, and to protect both patient and healthcare worker.
Step 1: Perform hand hygiene, and put on personal protective equipment: gown, gloves, mask and...