BACKGROUND. Currently, health professionals face the management of artificial airways in paediatric groups. This action requires delicate care and a lot of attention to detect, establish and manage pressing situations, in these cases being a greater risk of tracheo-pulmonary bacterial infections. OBJECTIVE. To identify and evaluate the scientific publications on infections in paediatric patients with tracheostomy tubes. MATERIAL AND METHODS. A systematic review of the years 2015-2020 was carried out, using the Elsevier, PubMed, Google Academic and Scielo databases, considering the population aged between 0-20 years who used a tracheostomy tube. RESULTS. From 322 articles distributed in the databases, 13 articles that met the inclusion criteria were selected. Comorbidities that were described as most frequently associated with infection of the tracheostomy tube in children were: neuromuscular disease, prematurity, ventilator use, congenital anomalies, chronic lung disease, obstruction airway, cystic fibrosis, and heart disease. The factors associated with length of stay (LOS) were the age from 30 days to 12 months, with a greater probability of re-entering the hospital and the presence of 4 or more complex chronic diseases. Regarding respiratory infections in patients with tracheostomy, P. aeruginosa was the most frequent bacteria present in cultures (90%), followed by Staphylococcus aureus. CONCLUSION. Although there are currently clinical criteria, risk factors and laboratory tests associated with infections of the post-tracheostomy tube in paediatric patients, further research is required to define clinical guidelines for the management in medical decision-making cases.
Pneumosinus dilatans is a rare disease characterized by air-filled expansion of a paranasal sinus. Approximately 134 cases are reported in the literature, but not only one associated with infantile cerebral palsy (ICP) and nasal polyposis. We herein present this case report aimed to further characterize this uncommon condition: a 28-year-old female diagnosed with infantile cerebral palsy and nasal polyposis, in whom the cranio-facial CT scan revealed the association of a pneumosinus dilatans involving the frontal sinus. The patient is currently undergoing a protocol for endoscopic surgery of the nose and paranasal sinuses.
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