Priti Hajare, Chenchulakshmi Vasudevan* and Rajesh Havaldar

Department of Otorhinolaryngology and Head and Neck Surgery, KAHER, India

*Corresponding Author: Chenchulakshmi Vasudevan, Department of Otorhinolaryngology and Head and Neck Surgery, KAHER, India.

Received: February 17, 2023; Published: March 24, 2023

Abstract

Otolaryngologists have long been concerned with pediatric airway care because of the vast range of problems that can arise in these situations. Tracheostomy was practiced in Greece, according to historical documents, and ever since it has served as the cornerstone of medical administration. Through bypassing any upper airway obstructive pathology, pediatric tracheostomy lessens dead space and, hence, the lung work load. It also gives access to suction and airway clearing. As medical technology has advanced throughout time, the indications and length of tracheostomies done on pediatric patients have changed. Our aim was to study the indications and the timing of performing tracheostomy in paediatric population at a tertiary care set up and to assess the complications and outcome for successful decannulation.

The most frequent cause for prologed tracheostomy was Guillain Barre in children. They had good outcomes, including successful decannulation once their general health stabilized. The most frequent cause of death in our research population was cardiac arrest, with tube displacement and lower respiratory tract infection as the most frequent sequelae. Longer tracheostomy durations with a delay in decannulation were linked to longer PICU stays and longer hospital stays. The decannulation was successful in almost all instances, but the socioeconomic status, carer awareness, and general health of the patient determined the speed of weaning off and post-tracheostomy rehabilitation. Even in a developing nation like ours, improved access to intensive care units and medical progress have changed the way that children tracheostomies are thought of.

Keywords: Pediatric Tracheostomy; Tracheostomy; Airway Management; GB Syndrome; Prolonged Intubation

References

1. Kolb Caroline M., et al. "Comparing decannulation failures and successes in pediatric tracheostomy: An 18‐year experience”. Pediatric Pulmonology8 (2021): 2761-2768.
2. Ogilvie Lauren N., et al. "Changes in pediatric tracheostomy 1982–2011: a Canadian tertiary children's hospital review”. Journal of Pediatric Surgery11 (2014): 1549-1553.
3. de Trey Lorraine, et al. "Pediatric tracheotomy: a 30-year experience”. Journal of pediatric Surgery7 (2013): 1470-1475.
4. Al-Samri Mohammed, et al. "Tracheostomy in children: a population‐based experience over 17 years”. Pediatric Pulmonology5 (2010): 487-493.
5. Mahadevan Murali., et al. "Pediatric tracheotomy: 17 year review”. International Journal of Pediatric Otorhinolaryngology12 (2007): 1829-1835.
6. Funamura Jamie L., et al. "Pediatric tracheotomy: indications and decannulation outcomes”. The Laryngoscope8 (2014): 1952-1958.
7. Alladi An., et al. "Pediatric tracheostomy: a 13-year experience”. Pediatric Surgery International20 (2004): 695-698.
8. Roberts Jessica., et al. "Pediatric tracheostomy: a large single‐center experience”. The Laryngoscope5 (2020): E375-E380.
9. Yukkaldıran Ahmet and Ahmet Doblan. "Pediatric tracheostomy at a tertiary healthcare institution: a retrospective study focused on outcomes”. Indian Journal of Otolaryngology and Head and Neck Surgery (2020): 1-6.
10. Dal’Astra Ana Paula Ligoski., et al. "Tracheostomy in childhood: review of the literature on complications and mortality over the last three decades☆”. Brazilian journal of otorhinolaryngology83 (2017): 207-214.
11. Douglas CM., et al. "Paediatric tracheostomy—an 11 year experience at a Scottish paediatric tertiary referral centre”. International Journal of Pediatric Otorhinolaryngology10 (2015): 1673-1676.
12. Schweiger Cláudia., et al. "Tracheostomy in children: a ten-year experience from a tertiary center in southern Brazil☆,☆☆”. Brazilian Journal of Otorhinolaryngology83 (2017): 627-632.
13. Walgaard Christa, et al. "Tracheostomy or not: prediction of prolonged mechanical ventilation in Guillain–Barré syndrome”. Neurocritical Care26 (2017): 6-13.
14. Rath Jakob., et al. "Nerve conduction studies in Guillain-Barré syndrome: influence of timing and value of repeated measurements”. Journal of the Neurological Sciences420 (2021): 117267.
15. Lawn Nicholas D and Eelco FM Wijdicks. "Post‐intubation pulmonary function test in Guillain–Barré syndrome”. Muscle and Nerve: Official Journal of the American Association of Electrodiagnostic Medicine4 (2000): 613-616.
16. Fourrier François., et al. "A simple functional marker to predict the need for prolonged mechanical ventilation in patients with Guillain-Barré syndrome”. Critical Care1 (2011): 1-7.
17. Mateen Farrah J., et al. "Guillain–Barré Syndrome in India: Population-based validation of the Brighton criteria”. Vaccine52 (2011): 9697-9701.
18. Watters KF. “Tracheostomy in infants and children”. Respiratory Care 62 (2017): 799-825.
19. Yukkaldıran Ahmet and Ahmet Doblan. "Pediatric tracheostomy at a tertiary healthcare institution: a retrospective study focused on outcomes”. Indian Journal of Otolaryngology and Head and Neck Surgery (2020): 1-6.
20. Gilmore Jr B B and S A Mickelson. "Pediatric tracheotomy. Controversies in management”. Otolaryngologic Clinics of North America1 (1986): 141-151.
21. Hajare PS and Havaldar RR. “Benefits and challenges associated with the timing of tracheostomy in critically ill patients: experience at a tertiary intensive care unit”. International Journal of Otorhinolaryngology and Head and Neck Surgery 7 (2021): 978-82.
22. Karapinar Bülent., et al. "Pediatric bedside tracheostomy in the pediatric intensive care unit: six-year experience”. Turkish Journal of Pediatrics4 (2008).
23. Akcan Fatih Alper., et al. "Pediatric tracheotomies: a 5-year experience in 152 children”. ENT Updates2 (2018): 71-78.

Citation

Citation: Chenchulakshmi Vasudevan., et al. “Unraveling the Evolving Trends of Pediatric Tracheostomy- An Overview at a Tertiary Care Center".Acta Scientific Otolaryngology 5.4 (2023): 32-36.

Copyright

Copyright: © 2023 Chenchulakshmi Vasudevan., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.