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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.
Summary
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.
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