Update on Pediatric Tracheostomy: Indications, Technique, Education, and Decannulation

Overview

Journal Curr Otorhinolaryngol Rep

Specialty Otorhinolaryngology

Date 2021 Apr 20

PMID 33875932

Citations 10

Authors

Colin Fuller

Andre M Wineland

Gresham T Richter

Affiliations

Soon will be listed here.

Abstract

Purpose Of Review: Tracheostomy in a child demands critical pre-operative evaluation, deliberate family education, competent surgical technique, and multidisciplinary post-operative care. The goals of pediatric tracheostomy are to establish a safe airway, optimize ventilation, and expedite discharge. Herein we provide an update regarding timing, surgical technique, complications, and decannulation, focusing on a longitudinal approach to pediatric tracheostomy care.

Recent Findings: Pediatric tracheostomy is performed in approximately 0.2% of inpatient stays among tertiary pediatric hospitals. Mortality in children with tracheostomies ranges from 10-20% due to significant comorbidities in this population. Tracheostomy-specific mortality and complications are now rare. Recent global initiatives have aimed to optimize decision-making, lower surgical costs, reduce the length of intensive care, and eliminate perioperative wound complications. The safest road to tracheostomy decannulation in children remains to be both patient and provider dependent.

Summary: Recent literature provides guidance on safe, uncomplicated, and long-term tracheostomy care in children. Further research is needed to help standardize decannulation protocols.

Citing Articles

Trend of Pediatric Tracheostomy in Taiwan: A Population-Based Survey from 2000 to 2019.

Kang K, Lee C, Lin C, Hsu W J Otolaryngol Head Neck Surg. 2024; 53:19160216241293069.

PMID: 39508458 PMC: 11544664. DOI: 10.1177/19160216241293069.

Decannulation protocol in pediatric patients: case series study.

de Miranda L, Borges L, Zavaglia L, Mesquita T, Leite L, Aguiar L Rev Paul Pediatr. 2024; 43:e2023187.

PMID: 39319994 PMC: 11421412. DOI: 10.1590/1984-0462/2025/43/2023187.

Evaluation of Tracheostomy Patients in Our Pediatric Intensive Care Unit: A Single-Center Study.

Kolbasi B, Senkal E, Taskesen M Cureus. 2024; 16(8):e66620.

PMID: 39258088 PMC: 11386230. DOI: 10.7759/cureus.66620.

Multidisciplinary Management of a Pediatric Patient With Congenital Anomalies Syndrome Without an Identified Genetic Mutation.

Song S, Louis Okoro O Cureus. 2024; 16(7):e64530.

PMID: 39139328 PMC: 11321745. DOI: 10.7759/cureus.64530.

Pediatric Tracheostomy Year in Review.

Willis L Respir Care. 2024; 69(8):1025-1032.

PMID: 38626953 PMC: 11298220. DOI: 10.4187/respcare.11932.

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