Tracheostomy

Abstract

The indications for paediatric tracheostomies are divided into three main categories: upper airway obstruction, assisted ventilation, and pulmonary toilet. The most common indications have changed over the years, from upper airway obstruction secondary to infectious disorders to the current most common indication of prolonged ventilation. Paediatric tracheostomies place a significant amount of stress on the child and the carers, making social and verbal development more challenging, so alternatives to tracheostomy should be explored first. Currently, the indication to tracheotomise a child is generally ruled by the anticipation of long-term cardiopulmonary compromise or by the presence of a fixed upper airway obstruction that is unlikely to resolve for a significant period. The goal is an orderly, well-timed procedure with an experienced surgeon and the best personnel and equipment possible.