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Characteristics of tracheostomized patients followed up by a Palliative Care and Complex Chronic Patient Service

Gemma Pons-Tomàs1, Rodrigo Morales Painamil1, Sílvia Ricart Campos2

  • 1Servicio de Pediatría, Hospital Sant Joan de Déu, Barcelona, Spain.

Anales De Pediatria
|April 11, 2024
PubMed

Insights

This study highlights the complex needs of children with tracheostomies, noting frequent bacterial infections and significant social challenges. Coordinated care and trained caregivers are crucial for managing these pediatric patients.

Area of Science:

  • Pediatric Medicine
  • Respiratory Care
  • Palliative Care

Background:

  • Increasing prevalence of pediatric tracheostomies necessitates a deeper understanding of patient characteristics.
  • The Department of Palliative Care and Chronic Medically Complex Illness (DPCCMCI) manages a growing cohort of these children.

Purpose of the Study:

  • To characterize pediatric patients with tracheostomies followed by a tertiary care hospital's palliative care department.
  • To analyze epidemiological, clinical, microbiological, and social factors in this population.

Main Methods:

  • Retrospective observational study of 44 tracheostomized patients (<18 years).
  • Data collected from November 2020 to June 2022 via health record review.
  • Analysis encompassed demographics, clinical conditions, microbiology, and social determinants.

Main Results:

  • Acquired upper airway disease was the most frequent underlying condition (20.5%).
  • Upper airway obstruction was the primary indication for tracheostomy (66%).
  • High rates of bacterial isolates (84%) in tracheal aspirates, with P. aeruginosa prevalent (56.8%).
  • Significant antibiotic use, including intravenous therapy and multiple systemic regimens.
  • Over half of children attended school (59%), with social difficulties reported in 53.7% and financial support needed by 22.7%.

Conclusions:

  • Integral and coordinated management is essential for complex tracheostomized pediatric patients.
  • Schooling is feasible and safe for these children with adequate caregiver training.
Abstract

Keywords:
Infecciones respiratoriasPaediatricsPediatríaRespiratory tract infectionsTracheostomyTracheotomyTraqueostomíaTraqueotomía

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