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Update on Pediatric Tracheostomy: Indications, Technique, Education, and Decannulation

Colin Fuller1,2, Andre' M Wineland1,2, Gresham T Richter1,2

  • 1Department of Otolaryngology, Head and Neck Surgery, University of Arkansas for Medical Sciences, 1 Children's Way, Little Rock, AR 72202 USA.

Current Otorhinolaryngology Reports
|April 20, 2021
PubMed

Insights

Pediatric tracheostomy requires careful evaluation, education, and care. While tracheostomy-specific complications are rare, standardizing decannulation protocols for children is crucial for safe, long-term airway management.

Area of Science:

  • Pediatric Surgery
  • Respiratory Medicine
  • Critical Care

Background:

  • Pediatric tracheostomy is a complex procedure requiring comprehensive pre-operative assessment.
  • Effective family education and multidisciplinary post-operative care are essential for successful outcomes.
  • The primary goals include securing a safe airway, optimizing ventilation, and facilitating patient discharge.

Purpose of the Study:

  • To provide an updated review on pediatric tracheostomy care.
  • To focus on timing, surgical techniques, complication management, and decannulation strategies.
  • To emphasize a longitudinal approach to managing pediatric tracheostomies.

Main Methods:

  • Review of recent literature on pediatric tracheostomy.
  • Analysis of current practices in tertiary pediatric hospitals.
  • Discussion of global initiatives to optimize tracheostomy care.

Main Results:

  • Pediatric tracheostomy occurs in about 0.2% of tertiary pediatric hospital inpatient stays.
  • Mortality in children with tracheostomies is 10-20% due to comorbidities; tracheostomy-specific mortality is rare.
  • Global initiatives aim to improve decision-making, reduce costs, shorten intensive care stays, and prevent wound complications.

Conclusions:

  • Recent literature offers guidance for safe, uncomplicated, long-term pediatric tracheostomy care.
  • Further research is necessary to standardize decannulation protocols in children.
  • The safest path to decannulation is patient and provider dependent.
Abstract

Keywords:
Bronchopulmonary DysplasiaClinical ReviewsPediatricsTracheaTracheostomy

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