Tracheostomy in children: Recommendations for a safer technique

Area of Science:

• Pediatric Surgery
• Respiratory Medicine
• Critical Care

Background:

• Tracheostomy in children has increased due to improved survival rates in premature infants and those with congenital anomalies.
• Indications for pediatric tracheostomy have evolved, necessitating a review of current practices.
• Lack of consensus exists regarding optimal timing and procedural approaches for pediatric tracheostomy.

Purpose of the Study:

• To review literature on pediatric tracheostomy, focusing on safety improvements.
• To outline indications, preoperative considerations, and surgical techniques for pediatric tracheostomy.
• To discuss post-operative care and decannulation protocols, emphasizing an interdisciplinary approach.

Main Methods:

• Comprehensive literature review of pediatric tracheostomy.
• Step-by-step description of surgical tracheostomy with safety emphasis.
• Analysis of post-operative care protocols and decannulation strategies.

Main Results:

• Surgical tracheostomy remains a primary method in pediatrics, with percutaneous approaches lacking sufficient evidence for routine use.
• Significant variability exists in tracheostomy care protocols, underscoring the need for standardization.
• Growing evidence supports an interdisciplinary approach for managing pediatric tracheostomized patients.

Conclusions:

• Standardizing pediatric tracheostomy procedures and post-operative care is crucial for patient safety.
• Further research is needed to establish evidence-based guidelines for pediatric tracheostomy timing and percutaneous techniques.
• An interdisciplinary team approach is essential for optimal outcomes in pediatric tracheostomized patients.