[The child with a tracheostomy, past and present: different indications, different children, different care].
--Until a few decades ago, acute infectious airway obstruction was the primary indication for tracheotomy in children. Its incidence has decreased considerably due to vaccination programmes and antibiotic treatment. --Today, the primary reasons for performing tracheotomy in a child are chronic airway obstruction (laryngeal injury after intubation, craniofacial malformation, lymphangioma) and prolonged artificial ventilation. --Consequently, the percentage of children who may be decannulated after a short period has decreased. --Tracheotomised children now require longer and more intensive care than before. --Hospital discharge is possible if parents and care providers are provided thorough training and counselling; this process requires specific medical, nursing and psychosocial support. --The increasing proportion of tracheotomised children cared for at home necessitates greater involvement from family practitioners.
Erasmus MC-Sophia Kinderziekenhuis, Dr. Molewaterplein 60, 3015 GJ Rotterdam. l.j.hoeve@erasmusmc.nl
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D000402:Airway Obstruction / Q000628:therapy*; D017028:Caregivers; D002648:Child; D005194:Family Practice / Q000639:trends*; D006699:Home Care Services / Q000639:trends*; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects / Q000639:trends; D007818:Laryngeal Diseases / Q000150:complications / Q000628:therapy; D012121:Respiration, Artificial / Q000009:adverse effects; D014140:Tracheotomy / Q000379:methods / Q000639:trends*