title: Early tracheostomy tube change in children.
abstract: OBJECTIVE
  To review the safety of early tracheostomy tube change in children.
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  Pediatric tertiary care hospital.
  
  
  METHODS
  Twenty-one consecutive pediatric patients undergoing routine tracheotomy.
  
  
  METHODS
  First tracheostomy tube change performed at patient's bedside at 3 (n = 15) or 4 (n = 5) days after surgery.
  
  
  METHODS
  The ability to safely change a tracheostomy tube at the patient's bedside 3 or 4 days after surgery.
  
  
  RESULTS
  The first tracheostomy tube change was safely performed at 3 or 4 days after surgery in 20 patients. All changes were accomplished without complication or difficulty on the first attempt. The patients' ages ranged from 4 days to 16 years. The smallest child weighed 1.6 kg. Early tracheostomy tube change was not attempted in one obese 10-year-old girl whose pediatric tracheostomy tube became dislodged and formed a false tract 2 days after surgery.
  
  
  CONCLUSIONS
  Most pediatric tracheostomy tubes can be safely changed at the patient's bedside approximately 3 days after surgery. Clinical applications of early tracheostomy tube change may include facilitating better hygiene, earlier completion of family caregiver tracheotomy education, and shorter hospital stays. It appears safe and advantageous for surgeons to consider early initial tracheostomy tube change for pediatric patients.
authors.affiliation: Department of Surgery, Alfred I. duPont Hospital for Children, Wilmington, Del 19899, USA.
authors.forename: E S
authors.initials: ES
authors.lastname: Deutsch
mesh_terms: D002648:Child; D002675:Child, Preschool; D004867:Equipment Design; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008173:Lung Diseases, Obstructive / Q000534:rehabilitation; D008297:Male; D011182:Postoperative Care; D012121:Respiration, Artificial; D013536:Suture Techniques; D014139:Tracheostomy / Q000295:instrumentation*; D014945:Wound Healing / Q000502:physiology*