RT Journal Article
SR Electronic
T1 Pediatric tracheostomy: Indications and complications rate. An experience from a semi-intensive pediatric respiratory unit
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP p4574
VO 38
IS Suppl 55
A1 Schiavino, Alessandra
A1 Rossi, Francesco Paolo
A1 Paglietti, Maria Giovanna
A1 Testa, Maria Beatrice Chiarini
A1 Salerno, Teresa
A1 Cutrera, Renato
YR 2011
UL http://erj.ersjournals.com/content/38/Suppl_55/p4574.abstract
AB Tracheostomy in children can be used to provide respiratory support as long-term ventilation/pulmonary toilet, or to bypass proximal airway obstruction. Tracheostomy is burdened by early and late complications which could make difficult hospital and home management.We performed a single centre Survey from September 2008 to September 2010, identifying early and late complications with the aim to assess the most frequent problems related to tracheostomy management in children.We administered to the parents a questionnaire in which the different topics were analyzed (indications to tracheostomy, operational tecnique, occurrence of intraoperative, early postoperative (within 24 - 48 hours) and late (after 48 hours) complications and the home care management).In the 2 years period we evaluated 66 patients (M/F 36/30, mean age 7 years). Indications to tracheostomy were prolonged endotracheal intubation followed by tracheal malacia or stenosis, chronic respiratory failure, central apnoeas and vocal cord paralysis. Patients were affected by genetic or metabolic disorders, cerebral palsy, neuromuscular diseases, congenital heart diseases, tracheal diseases and tumors of the nervous system.In 65% of cases no complications occurred, while in 5% early complications and in 35% late complications occurred. Only 4 patients died during the Survey period, but not due to tracheostomy complication.Tracheostomy allows to manage different severe disease in children. The indications for its use have changed over the past decades. Late-onset complications are the most frequent and their knowledge allows to manage the trachestomized patient from hospital staff and home caregivers.