title: Association of rapid head growth in children following tracheostomy tube placement.
abstract: BACKGROUND
  Our clinical observation indicates that some children who have a tracheostomy may experience increasing head circumference as they grow and develop. Accurate assessment and interpretation of growth parameters is an essential component of following child development. Appreciation for variations in growth is especially important in special populations, such as children with a tracheostomy. The aim of this study is to define head growth in children with a tracheostomy.
  
  
  METHODS
  This retrospective cohort study includes children who underwent tracheostomy tube placement prior to 2 years of age in a respiratory rehabilitation unit within a children's hospital. Serial head circumference measurements were plotted against age on growth charts adjusted for gestational age. The percentage of patients with accelerated head growth, defined as increased head circumference across two major percentiles within 6 months following tracheostomy, was determined.
  
  
  RESULTS
  Fifty-seven percent (20 out of 35 children) demonstrated increased head circumference across two major percentiles within 6 months following tracheostomy.
  
  
  CONCLUSIONS
  Accelerated head growth is associated with the presence of a tracheostomy tube in children in this study. Further investigation is warranted to establish the relationship of head circumference to other growth parameters. In addition, the etiology of this phenomenon requires additional study. Understanding head growth in children with a tracheostomy will promote adequate growth assessment and may lead to improved patient care.
authors.affiliation: Department of Anesthesiology and Critical Care, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA. thompsona@email.chop.edu
authors.forename: Allison
authors.initials: A
authors.lastname: Thompson
authors.forename: Daniela H
authors.initials: DH
authors.lastname: Davis
authors.forename: Troy E
authors.initials: TE
authors.lastname: Dominguez
authors.forename: Steven
authors.initials: S
authors.lastname: Schultz
authors.forename: Lauren
authors.initials: L
authors.lastname: Marlowe
authors.forename: Jimmy W
authors.initials: JW
authors.lastname: Huh
authors.forename: Mark A
authors.initials: MA
authors.lastname: Helfaer
mesh_terms: D005260:Female; D006257:Head / Q000254:growth & development*; D006330:Heart Defects, Congenital / Q000628:therapy*; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D012121:Respiration, Artificial; D012189:Retrospective Studies; D014139:Tracheostomy