Guilherme Movio
Background: Paediatric Tracheostomy is a procedure used to ventilate children through a hole in the trachea. Indications for the procedure were once primarily for acute upper airway obstruction, due to infections. Generally, there is poor knowledge surrounding tracheostomies with limited awareness of guidelines amongst health-care professionals.
Aim: To discuss the rationale for changes to the indications for tracheostomy in the paediatric population. I will also investigate the key complications related to the procedure and discuss the importance of awareness of an emergency algorithm for the multidisciplinary team.
Findings: Indications have changed due to advancements in medicine which have increased the life expectancy and survival rates of children with often life-threatening congenital conditions. Tracheostomies can offer these children long term ventilatory support. Upper airway obstructions due to infections are less frequent indications due to long running and successful vaccination programs. Current complications of tracheostomy are due to acute obstruction and inadvertent decannulation. Intra-operative complications are infrequent, due to refinement of surgical technique.
Conclusion: Paediatric airway management is a rapidly evolving field because of continuous advancements in neonatal and intensive care medicine. The indications and complications have changed over the last four decades. A greater understanding of tracheostomy complications amongst health-care professionals is required for better management.