title: Tracheostomy: indications and complications in paediatric patients.
abstract: Despite advances in non-invasive ventilation techniques, tracheostomy is still indicated in children with serious airway obstruction or with the need for long-term ventilation. Alternatives should be studied before deciding to tracheostomise as complications exist, despite the simple procedure. The aims of this study were the identification of tracheostomised children followed in a tertiary care paediatric department, the characterisation of primary disease, the indications leading to tracheostomy and any complications. We present a case review of tracheostomised children followed in our department. Sixteen tracheostomised children were followed, median age of 4.5 months, neuromuscular disease - 5, cerebral palsy - 3 and pulmonary or airway disease - 7. Indications were long-term invasive ventilation - 12, subglottic or tracheal stenosis - 3 and laryngomalacia - 1. The most frequent complications found were persistent bacterial colonisation, accidental decannulation and obstruction. There was a tracheostomy- related death in 1 child.
  
  
  RESULTS
  9 children maintained tracheostomy, 5 were successfully decannulated and 2 children died while on tracheostomy. Tracheostomised children usually have complex disease that requires a multidisciplinary team and should be followed-up at a specialised reference centre.
authors.affiliation: Interno do internato complementar de pediatria do Hospital de Santa Maria / Resident, Paediatrics, Hospital de Santa Maria.
authors.forename: Artur
authors.initials: A
authors.lastname: Sousa
authors.forename: Teresa
authors.initials: T
authors.lastname: Nunes
authors.forename: Rosa
authors.initials: R
authors.lastname: Roque Farinha
authors.forename: Teresa
authors.initials: T
authors.lastname: Bandeira
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D014139:Tracheostomy / Q000009:adverse effects