RT Journal Article
SR Electronic
T1 Review of a children’s complex airway clinic
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 3522
DO 10.1183/13993003.congress-2020.3522
VO 56
IS suppl 64
A1 Teresa MacCarrick
A1 Ravi Sharma
A1 Andrew Selby
YR 2020
UL http://erj.ersjournals.com/content/56/suppl_64/3522.abstract
AB Introduction: Children with tracheostomies require regular review to monitor optimal tube size and complications. We set up a multidisciplinary complex airway clinic for children with tracheostomies/long term ventilation, run jointly by consultants in paediatric otolaryngology and long term ventilation. During clinic visits, dynamic airway examination in the patient's usual position is undertaken by flexible endoscopy.Aim: To review the acceptability and effectiveness of our paediatric complex airway clinic.Methods: Clinic letters for attendences from 2013-2019 were reviewed. Relevent airway endoscopy findings and changes in patient management were recorded.Results: 53 children with tracheostomies were seen in 164 clinic visits. Median age at first clinic visit was 6years 3months (range 7months to 24years). Flexible endoscopy with and without the tube in place was carried out in 157 clinic visits. Granulation tissue of the tracheal mucosa was seen in 8 patients, at the stoma site in 12 patients, and 2 patients had both. There was no clear relationship between granulation occurance and tube type, cuff usage, freqency of tube change or type of tube tie. 20 clinic visits led to a change in tracheostomy tube. New advice about secretion management, tube changes, tube fixation or skincare was given in 97 clinic visits. Only 4 patients required a general anaesthetic for suprastomal assessment for decannulation.Conculsion: Our complex airway clinic is highly effective in monitoring children with tracheostomys. General anaesthetic for airway assessment is only needed prior to decannulation or for management of complex granulation tissue. Parents feel included in decision-making and have improved confidence managing their child's tracheostomy.FootnotesCite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 3522.This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).