Clinical experience of paediatric self-expanding foam cuffed tracheostomy tubes

Area of Science:

• Pediatric Otolaryngology
• Respiratory Medicine
• Medical Device Technology

Background:

• Self-expanding foam-filled tracheostomy tube cuffs (Bivona FOME cuf) are increasingly used in pediatric patients with intractable aspiration.
• Limited literature exists on clinical indications, management, and outcomes for these devices in children.
• This study details institutional experience with a cohort of pediatric patients requiring foam-cuffed tracheostomy tubes.

Purpose of the Study:

• To describe the indications for using foam-cuffed tracheostomy tubes in pediatric patients.
• To report on the outcomes and management strategies, including emergency care, for children with these devices.
• To highlight the utility and challenges associated with Bivona FOME cuf tracheostomy tubes in a pediatric population.

Main Methods:

• A retrospective review of pediatric patients at Great Ormond Street Hospital who received a Bivona FOME cuf tracheostomy tube.
• Analysis of indications for tube insertion, patient progress, and subsequent management.
• Review of emergency care protocols and outcomes, including specific case management.

Main Results:

• Ten pediatric patients were identified, primarily indicated for chronic respiratory infections due to aspiration.
• All patients demonstrated improved chest function post-insertion without cuff trauma.
• One case of accidental port line damage during removal was managed with a specific strategy, highlighting potential challenges.

Conclusions:

• Foam-cuffed tracheostomy tubes are beneficial for managing chronic aspiration in children with compromised chest health.
• Lack of widespread knowledge necessitates further educational resources on the indications, routine care, and emergency management of Bivona FOME cuf tubes.
• These tubes represent a valuable option for pediatric institutions managing complex aspiration cases.