Pediatric tracheostomy.
OBJECTIVE
To provide an up-to-date review of pediatric tracheostomy, primarily focusing on indications, surgical technique, complications and hospital and home care.


METHODS
MEDLINE and PubMed databases were searched using the following keywords: tracheostomy, tracheotomy, children, newborn.


RESULTS
Indications for tracheostomy in children are changing. Today the most common indication is prolonged ventilation. The age at the time of the procedure has also changed, with a peak incidence of tracheostomy in patients less than 1 year old. Except under emergency conditions, pediatric tracheostomy should be performed in the operating room with the child intubated. A horizontal skin incision with vertical tracheal incision and no tracheal resection is recommended. Although post-tracheostomy complications are not uncommon, they usually do not need special treatment or surgical procedures. Tracheostomy mortality can occur in up to 40% of pediatric cases, however the tracheostomy-related mortality rate is only 0 to 6%.


CONCLUSIONS
The decision to perform a tracheostomy remains complex, and depends on several factors. The procedure is safe and with a low number of complications if carried out at a tertiary hospital by a trained and experienced team.
Fraga
José Carlos
JC
Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil. jc.fraga@terra.com.br
Souza
João C K de
JC
Kruel
Juliana
J
D000402:Airway Obstruction / Q000209:etiology / Q000601:surgery*; D002648:Child; D006801:Humans; D014139:Tracheostomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*