Pregledni rad
https://doi.org/10.20471/acc.2023.62.s1.14
Special Considerations in Pediatric Tracheostomy – A Narrative Review
Ana Kvolik Pavić
orcid.org/0000-0002-3991-6433
; Department of Maxillofacial and Oral Surgery, Osijek University Hospital, Osijek, Croatia; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
Luka Tabak
; Department of Maxillofacial and Oral Surgery, Osijek University Hospital, Osijek, Croatia; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
Ana-Maria Lazar
; Department of Maxillofacial and Oral Surgery, Osijek University Hospital, Osijek, Croatia; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
Josip Butković
; Department of Maxillofacial and Oral Surgery, Osijek University Hospital, Osijek, Croatia; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
Ivan Mumlek
; Department of Maxillofacial and Oral Surgery, Osijek University Hospital, Osijek, Croatia; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
Silva Guljaš
; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; Department of Diagnostic and Interventional Radiology, Osijek University Hospital, Osijek, Croatia
Vedran Zubčić
; Department of Maxillofacial and Oral Surgery, Osijek University Hospital, Osijek, Croatia; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
Sažetak
Surgical tracheostomy is a life-saving procedure performed for emergent or expectant
airway compromise. Morbidity in the pediatric population is higher than in adults due to smaller
operating field, immaturity of tissues, anatomic specificities of the child’s neck, or the presence of craniofacial
dysmorphism. The procedure varies among surgeons regarding the position of the skin incision
(vertical or horizontal), resection of the subcutaneous adipose tissue and isthmus of the thyroid gland,
use of tracheal flaps, and use of maturation or stay sutures. Both early and late complications can be
life-threatening, and include accidental decannulation, stomal plugging, bleeding, and difficult ventilating.
Consistent tracheostomal care is crucial in avoiding complications. Primary caregivers must be
included and educated about proper stomal care. Decannulation failures are common. Prerequisites for
safe decannulation include non-dependence on mechanical ventilation and no recent aspiration events,
positive endoscopic airway assessment, and successful daytime capping. The role of polysomnography
in decannulation protocols is debated. Although seldom performed, tracheostomy is the procedure of
choice in a selected group of pediatric patients. The risks and benefits of the procedure must be weighed
for each patient. The education of medical personnel and caregivers is key to reducing serious complications.
Ključne riječi
Pediatrics; Tracheotomy; Tracheostomy, postoperative complications; Airway management
Hrčak ID:
307513
URI
Datum izdavanja:
1.4.2023.
Posjeta: 250 *