Abstract
Pediatric patients for whom tracheotomy is a consideration have different anatomy, medical conditions, and prognoses than adults; even the tracheotomy tubes are different. Indications for pediatric tracheotomy generally include bypassing airway obstruction, providing access for prolonged mechanical ventilation, and facilitating tracheobronchial toilet. Subglottic stenosis is an important indication for tracheotomy in children; its etiology, prevention, and alternative options for management are presented. Discussion includes the benefits, risks, impact on families, techniques for tracheotomy tube changes, and alternatives to tracheotomy, with illustrative photographs and diagrams.
Footnotes
- Correspondence: Ellen S Deutsch MD, Center for Simulation, Advanced Education, and Innovation, The Children's Hospital of Philadelphia, 3400 Civic Center Boulevard, 8NW100, Philadelphia PA 19104. E-mail: deutsches{at}email.chop.edu.
Dr Deutsch presented a version of this paper at the 25th New Horizons Symposium, “Airway Management: Current Practice and Future Directions,” at the 55th International Respiratory Congress of the American Association for Respiratory Care, held December 5–8, 2009, in San Antonio, Texas.
The author has disclosed no conflicts of interest.
- Copyright © 2010 by Daedalus Enterprises Inc.
