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Jornal de Pediatria
On-line version ISSN 1678-4782
FRAGA, José Carlos; SOUZA, João C. K. de and KRUEL, Juliana. Pediatric tracheostomy. J. Pediatr. (Rio J.) [online]. 2009, vol.85, n.2, pp. 97-103. ISSN 1678-4782. http://dx.doi.org/10.1590/S0021-75572009000200003.
OBJECTIVE: To provide an up-to-date review of pediatric tracheostomy, primarily focusing on indications, surgical technique, complications and hospital and home care. SOURCES: MEDLINE and PubMed databases were searched using the following keywords: tracheostomy, tracheotomy, children, newborn. SUMMARY OF THE FINDINGS: Indications for tracheostomy in children are changing. Today the most common indication is prolonged ventilation. The age at the time of the procedure has also changed, with a peak incidence of tracheostomy in patients less than 1 year old. Except under emergency conditions, pediatric tracheostomy should be performed in the operating room with the child intubated. A horizontal skin incision with vertical tracheal incision and no tracheal resection is recommended. Although post-tracheostomy complications are not uncommon, they usually do not need special treatment or surgical procedures. Tracheostomy mortality can occur in up to 40% of pediatric cases, however the tracheostomy-related mortality rate is only 0 to 6%. CONCLUSIONS: The decision to perform a tracheostomy remains complex, and depends on several factors. The procedure is safe and with a low number of complications if carried out at a tertiary hospital by a trained and experienced team.
Keywords : Tracheostomy; tracheotomy; prolonged intubation; children; newborn.