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International Pediatric Otolaryngology Group (IPOG) consensus recommendations: Management of suprastomal collapse in
Jaime Doody1, Ahmed Alkhateeb2, Karthik Balakrishnan3
1Department of Otolaryngology/Head and Neck Surgery, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
Insights
Suprastomal collapse (SuStCo) in children with tracheostomies is a common issue. This study offers a new classification and management strategies for significant SuStCo to aid safe decannulation.
Area of Science:
- Pediatric Otolaryngology
- Airway Management
- Surgical Complications
Background:
- Suprastomal collapse (SuStCo) is a frequent complication following prolonged tracheostomy in pediatric patients.
- Limited literature exists on managing significant SuStCo that impedes safe decannulation.
- This condition affects children requiring tracheostomy tubes.
Purpose of the Study:
- To define suprastomal collapse in children.
- To establish a classification system for SuStCo severity.
- To recommend management strategies for significant pediatric SuStCo.
Main Methods:
- Survey of International Pediatric Otolaryngology Group (IPOG) experts.
- Modified Delphi method for refining results.
- Achieved consensus on diagnosis and management.
Main Results:
- Established consensus (>70% agreement) among pediatric airway experts.
- Developed a classification system for SuStCo.
- Identified consensus-based management options for SuStCo.
Conclusions:
- Provides a consensus statement for managing pediatric SuStCo.
- Offers a classification system to aid diagnosis.
- Recommends treatment options for children with tracheostomies and SuStCo.
Introduction:
Suprastomal Collapse (SuStCo) is a common complication of prolonged tracheostomy in children. There is a paucity of literature on this subject, especially regarding how to manage significant suprastomal collapse that prevents safe decannulation.
Objective:
Provide a definition, classification system, and recommend management options for significant suprastomal collapse in children with tracheostomy.
Methods:
Members of the International Pediatric Otolaryngology Group (IPOG) who are experts in pediatric airway conditions were surveyed and results were refined using a modified Delphi method.
Results:
Consensus was defined as > 70% agreement on a subject. The experts achieved consensus: CONCLUSION: This consensus statement provides recommendations for medical specialists who manage infants and children with tracheostomies with significant Suprastomal Collapse. It provides a classification system to facilitate diagnosis and treatment options for this condition.
