Tracheostomy in children

Key Points: Children needing a tracheostomy are more likely to be less than one year of age. Tracheostomy is indicated in children for one of three reasons: Prolonged ventilator dependence (usually due to lung disease of prematurity) Upper airway obstruction (including congenital, acquired, and craniofacial etiologies) Increased need for pulmonary toilet (underlying neurological disease) Management of a tracheostomy in a child requires an interdisciplinary team of medical professionals who can assist with postoperative care, education, and therapy for the child and his or her family. Tracheostomy-related deaths have decreased in incidence, but still occur in up to 4% of children most commonly due to mucous plugging or accidental decannulation. Long-term complications of tracheostomy include tracheostomal granulation and persistent tracheocutaneous fistula after decannulation.