Decannulation and Outcome following Pediatric Tracheostomy

Abstract

Tracheostomy indication and patient diagnosis are significant variables that predict early decannulation in pediatric patients in whom tracheostomy is required. Other variables were not shown to be significant independent predictors.

Inpatient Observation for Elective Decannulation of Pediatric Patients With Tracheostomy

“…[5][6][7] Overall, there were 8 unsuccessful hospitalizations for elective decannulation in our study, for a hospitalization-specific failure rate of 16% and overall failure rate of 9%, which are in accord with published data. Although we were not able to identify statistically significant predictors of decannulation success or failure in this group, several interesting patterns did emerge.…”

Paediatric patients with a tracheostomy: a multicentre epidemiological study

“…A study of 54 patients with home mechanical ventilation (45 via tracheostomy and nine via nasal mask) reported that 66% of the severe emergencies were related to the tracheostomy [28]. Whereas infection is reported to be the main complication [26,27], as much as 90% in some series [6], in our series it only accounted for 8.8% of complications. This difference may be related to both the shorter follow-up and the question of differentiating infection versus colonisation, under-or overestimating the true incidence.…”

“…One of these studies found that patients ,1 yr of age had the tracheostomy for much longer periods (829 days) than children .1 yr (94 days) [3]. Another study analysed the possible risk factors related to the duration of the cannulation, noting that the only determining factors were the type of disorder and the indication for tracheostomy, but not the age of the patient [27]. It is nevertheless interesting to note that despite the chronicity and complexity of the patients, 79.5% of the survivors still managed to achieve social insertion appropriate for their age via the preschool/ school support system, independently of whether they had been decannulated or were receiving ventilatory support.…”

A Multidisciplinary Children’s Airway Center: Impact on the Care of Patients With Tracheostomy

“…5,[7][8][9][10][11][12][13] The team reached consensus that tracheostomy decannulation should be preceded by airway endoscopy and followed by a 24-to 48-hour hospital admission for observation. Patients decannulated in a location other than the operating room, bronchoscopy suite, or postanesthesia recovery room, decannulated without previous airway endoscopy, discharged <24 hours postdecannulation, or without a postdecannulation clinic visit within 6 weeks were considered to be outside the consensus guideline.…”