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Decannulation protocol in pediatric patients: case series study
Luciana Diniz Gomide de Miranda1, Luiza Araujo Alves Borges2, Laura Caldeira Zavaglia2
1Fundação Hospitalar do Estado de Minas Gerais, Hospital Infantil João Paulo II, Serviço de Assistência Integral à Criança Traqueostomizada, Belo Horizonte, MG, Brazil.
Insights
This study shows a safe decannulation protocol for children, with 23% successfully decannulated without complications. The protocol addresses upper airway obstruction and swallowing issues in pediatric patients.
Area of Science:
- Pediatric Otolaryngology
- Respiratory Medicine
- Pediatric Surgery
Background:
- Tracheostomy is often necessary for pediatric patients with upper airway obstruction, frequently caused by acquired subglottic stenosis.
- Decannulation protocols are crucial for managing children with tracheostomies, aiming for safe airway restoration.
- Assessing swallowing function and performing airway corrections are key steps prior to decannulation.
Purpose of the Study:
- To outline the phases of a pediatric decannulation protocol.
- To report the outcomes of applying this decannulation protocol in hospitalized children.
- To evaluate the safety and efficacy of the decannulation process.
Main Methods:
- Retrospective, observational study design.
- Data collected from medical records of decannulated pediatric patients (2011-2021).
- Analysis of patient demographics, reasons for tracheostomy, pre-decannulation interventions, and outcomes.
Main Results:
- 23% of 526 children were successfully decannulated (n=120).
- Mean age of decannulated children was 4 years; 69% were male.
- Pre-decannulation interventions included airway correction (39.5%), dilation (63.8%), and endoscopic correction (55.3%). No post-decannulation complications were reported.
Conclusions:
- The implemented decannulation protocol is safe for pediatric patients.
- No deaths or need for recannulation occurred following the protocol.
- Successful decannulation was achieved in a significant portion of the studied pediatric population.
Objective:
The aim of this study was to describe the phases of a decannulation protocol and the results from its application in hospitalized children.
Methods:
This is a retrospective, observational study. Data were collected from medical records of decannulated patients followed up in a pediatric hospital in Belo Horizonte, Minas Gerais between 2011 and 2021.
Results:
Among the children followed up in the service (n=526), 23% (n=120) were successfully decannulated. Children aged between 2 months and 16 years, with a mean age of 4 years, 69% of whom were male, were evaluated. About 75% of the patients have tracheostomy due to upper airway obstruction and 60% of these due to acquired subglottic stenosis. At the beginning of the decannulation protocol, 5.5% of the patients had moderate oropharyngeal dysphagia, while 80.4% had normal swallowing. Correction in the upper airway pre-decannulation was performed in 39.5% of the patients, dilation in 63.8%, and endoscopic correction was performed in 55.3%. After performing the decannulation, none of the patients had complications.
Conclusions:
The described decannulation protocol is safe, since no complications such as death and need for recannulation happened.
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