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Perspectives on neonatal and infant tracheostomy

Sara B DeMauro1, Julie L Wei2, Richard J Lin1

  • 1The Children's Hospital of Philadelphia, Philadelphia, PA, USA; The University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.

Seminars in Fetal & Neonatal Medicine
|April 11, 2016
PubMed

Insights

Neonates and infants may require tracheostomy for airway obstruction or mechanical ventilation. This review covers conditions, benefits, and side effects, influencing timing and potential airway recovery.

Area of Science:

  • Pediatric Otolaryngology
  • Neonatal Critical Care
  • Pediatric Respiratory Medicine

Background:

  • Neonates and infants often require tracheostomy due to airway obstruction or prolonged mechanical ventilation.
  • Numerous congenital and acquired conditions necessitate tracheostomy in pediatric patients.
  • Tracheostomy management involves complex decisions balancing benefits against potential short- and long-term side effects.

Purpose of the Study:

  • To present the pathophysiology of conditions managed with tracheostomy in neonates and infants.
  • To discuss the benefits and potential side effects of tracheostomy.
  • To inform decisions regarding the optimal timing and management of pediatric tracheostomy.

Main Methods:

  • Review of pathophysiology for congenital and acquired conditions requiring tracheostomy.
  • Analysis of short-term and long-term benefits and side effects.
  • Evaluation of factors influencing tracheostomy timing and outcomes.

Main Results:

  • Tracheostomy addresses critical airway issues in infants, including obstruction and ventilator dependence.
  • Potential complications and side effects must be weighed against the advantages.
  • Infant outcomes vary, with some achieving natural airway recovery and others requiring further surgical intervention.

Conclusions:

  • Tracheostomy is a vital intervention for specific pediatric respiratory conditions.
  • Careful consideration of risks, benefits, and underlying pathophysiology guides management decisions.
  • Long-term outcomes may necessitate airway reconstruction for some infants.

Keywords:
Bronchopulmonary dysplasiaChronic lung diseaseLaryngotracheal stenosisSubglottic stenosisTracheostomyVocal cord paralysis

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