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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
Summary
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.
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