What Are The Potential Complications of a Tracheostomy?

Discussion In the past, indications for tracheostomy were often because of infection, but today are more often due to need for chronic airway support and/or ventilation. Many more children and infants are having tracheostomies placed. Decannulation rates for these children are low due to concomitant complex chronic disease such as neurological, pulmonary and congenital heart diseases. Co-morbidies are common with 3-4 being average, and frequently also including chronic technology such as gastrostomy tubes or ventriculoperitoneal shunts. Approximately 8% of children do not survive the hospitalization where the tracheostomy is placed. It is believe this is not specifically due to the tracheostomy, but is secondary to underlying medical conditions. About 15-20% of children with tracheostomies have a tracheostomy-related complication and many have frequent hospitalizations. Frequent hospitalizations are often due to respiratory issues (50.8% with pneumonia accounting for 15.4%) and neurological and otolarygological problems accounting for 8.4% each in a 2015 study. Decannulation is highly individual and many children will need the tracheostomy for their lifetimes. In general before a decannulation attempt, there should be no ventilatory support needed for at least 3-6 months, no aspiration events, no need for supplemental oxygen, no need for elective surgery in the near future necessitating intubation, and co-morbidies that have resolved or are improved. Patients who are being c...
Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news