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Pediatric tracheostomy

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https://www.readbyqxmd.com/read/28984426/caregiver-knowledge-and-skills-to-safely-care-for-pediatric-tracheostomy-ventilation-at-home
#1
Reshma Amin, Chris Parshuram, Jeannie Kelso, Audrey Lim, Dimas Mateos, Ian Mitchell, Hema Patel, Madan Roy, Faiza Syed, Rita Troini, David Wensley, Louise Rose
OBJECTIVE: Caregivers of children using home mechanical ventilation (HMV) via tracheostomy require appropriate knowledge and skills. Existing training curricula are locally developed and content variable. We sought to develop a competency checklist to inform initial training and subsequent assessment of knowledge and skills of family caregivers. METHODS: We used a 2-step process. Candidate items were generated by synthesis of a scoping review, existing checklists, with additional items suggested by an eight member inter-professional group representing pediatric HMV programs across Canada...
October 6, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28983551/association-of-enrollment-in-an-aerodigestive-clinic-with-reduced-hospital-stay-for-children-with-special-health-care-needs
#2
Swathi Appachi, Anne Banas, Lisa Feinberg, Douglas Henry, Diane Kenny, Nathan Kraynack, Amy Rosneck, John Carl, Paul Krakovitz
Importance: Children with special health care needs (CSHCN) have disproportionate health care utilization. Previous studies have demonstrated that a primary medical home improves health care outcomes for this population. Objective: To elucidate if enrollment in a multidisciplinary aerodigestive clinic improves outcomes and reduces health care costs by decreasing admissions and inpatient days. Design, Setting, and Participants: A retrospective medical record review of 113 patients with aerodigestive disorders enrolled in a pediatric multidisciplinary clinic from June 2009 to December 2013 was performed...
October 5, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28950420/performance-of-a-tracheostomy-removal-protocol-for-pediatric-patients-in-rehabilitation-after-acquired-brain-injury-factors-associated-with-timing-and-possibility-of-decannulation
#3
Marco Pozzi, Sara Galbiati, Federica Locatelli, Emilio Clementi, Sandra Strazzer
OBJECTIVES: We assessed the performance of a tracheostomy decannulation protocol privileging safety over quickness, in pediatric patients undergoing rehabilitation from severe acquired brain injury. We analyzed factors associated with decannulation timing and possibility and examined cases of failure. HYPOTHESIS: A safe decannulation protocol should minimize failures. STUDY DESIGN: Retrospective observational study. PATIENT SELECTION: Patients aged 0-17 admitted to rehabilitation with tracheostomy in the last 15 years (n = 123)...
September 26, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28944533/parents-spend-an-average-of-nine-hours-a-day-providing-palliative-care-for-children-at-home-and-need-to-maintain-an-average-of-five-life-saving-devices
#4
P Lazzarin, B Schiavon, L Brugnaro, F Benini
AIM: This Italian study investigated home-based palliative care for young children and how long it took parents to meet their needs. METHODS: The study population consisted of 33 families with a child under the responsibility of the Veneto Regional Center for Pediatric Palliative Care, northern Italy, who needed medical support in at least two of the following areas: respiratory, feeding, pain and seizures. RESULTS: The children had a mean age of 6...
September 25, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28938289/discussing-benefits-and-risks-of-tracheostomy-what-physicians-actually-say
#5
Lauren M Hebert, Anne C Watson, Vanessa Madrigal, Tessie W October
OBJECTIVES: When contemplating tracheostomy placement in a pediatric patient, a family-physician conference is often the setting for the disclosure of risks and benefits of the procedure. Our objective was to compare benefits and risks of tracheostomy presented during family-physician conferences to an expert panel's recommendations for what should be presented. DESIGN: We conducted a retrospective review of 19 transcripts of audio-recorded family-physician conferences regarding tracheostomy placement in children...
September 21, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28928262/the-use-of-speaking-valves-in-children-with-tracheostomy-tubes-what-is-the-scope-of-the-literature
#6
Weeda Zabih, Theresa Holler, Faiza Syed, Laurie Russell, Jennifer Allegro, Reshma Amin
One-way speaking valves have been successfully used to restore audible meaningful speech in adult patients after tracheostomy tube placement. One-way speaking valves have also been used in pediatric patients after tracheostomy tube placement with promising results. We conducted a scoping review to synthesize and summarize the current evidence on the use of one-way tracheostomy tube speaking valves in the pediatric population to identify knowledge gaps that could inform future research programs and facilitate evidence-based clinical decision making...
September 19, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28887930/pediatric-extracorporeal-membrane-oxygenation
#7
REVIEW
Christopher Loren Jenks, Lakshmi Raman, Heidi J Dalton
Extracorporeal life support is a modified form of cardiopulmonary bypass. Experience in extracorporeal membrane oxygenation (ECMO) has come largely from the neonatal population. Most centers have transitioned the ECMO pumps from roller pumps to centrifugal technology. Modes of support include venovenous for respiratory support and venoarterial for cardiac support. "Awake" ECMO is the trend with extubation and tracheostomy on the rise. Fluid overload is common and managed with diuretics or hemofiltration. Nutrition is important and provided enterally or via total parenteral nutrition...
October 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/28839496/use-of-nasal-non-invasive-ventilation-with-a-ram-cannula-in-the-outpatient-home-setting
#8
Wilfredo De Jesus Rojas, Cheryl L Samuels, Traci R Gonzales, Katrina E McBeth, Aravind Yadav, James M Stark, Cindy Jon, Ricardo A Mosquera
BACKGROUND: Nasal non-invasive-ventilation (Nasal NIV) is a mode of ventilatory support providing positive pressure to patients via a nasal interface. The RAM Cannula is an oxygen delivery device that can be used as an alternative approach to deliver positive pressure. Together they have been successfully used to provide respiratory support in neonatal in-patient settings. OBJECTIVE: To describe the outpatient use of Nasal NIV/RAM Cannula as a feasible alternative for home respiratory support in children with chronic respiratory failure...
2017: Open Respiratory Medicine Journal
https://www.readbyqxmd.com/read/28822673/the-financial-impact-of-a-hospital-based-care-coordination-program-for-children-with-special-health-care-needs
#9
Janine M Petitgout
Care coordination programs are important in caring for medically complex pediatric patients, particularly for children with special health care needs. This study is a retrospective financial analysis of a hospital-based care coordination program involving one procedural subgroup of children with special health care needs: those receiving pediatric tracheostomy. Hospital records were reviewed for patients who received a tracheostomy at a large Midwestern U.S. hospital from 1999 through 2015. The population was divided into two subgroups: patients who received a tracheostomy before the development of a care coordination program and patients who received a tracheostomy after enrollment in the care coordination program...
August 16, 2017: Journal of Pediatric Health Care
https://www.readbyqxmd.com/read/28817750/the-surgeon-on-service-model-for-timely-economically-viable-inpatient-care-of-tracheostomy-patients-in-academic-pediatric-otolaryngology
#10
Jennifer M Lavin, James W Schroeder, Dana M Thompson
Importance: The traditional practice model for pediatric otolaryngologists at high-volume academic centers is to simultaneously balance outpatient care responsibilities with those of the inpatient service, emergency department, and ambulatory care clinics. This model leads to challenges with care coordination, timeliness of nonemergency operative care, and consistent participation in care and consultation at the attending surgeon level. The "surgeon on service" (SOS) model-where faculty members rotate to manage the inpatient service in lieu of outpatient responsibilities-has been described as one method to address this conundrum...
August 17, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28815624/morbidity-and-mortality-in-children-undergoing-bronchoscopy-for-foreign-body-removal
#11
Christopher A Roberts, Michele M Carr
OBJECTIVES/HYPOTHESIS: Analyze morbidity and mortality among children undergoing bronchoscopy for foreign body removal. STUDY DESIGN: Multicenter retrospective review using the American College of Surgeons Pediatric National Surgical Quality Improvement Program from 2014 and 2015. METHODS: Patients were identified using Current Procedural Terminology code 31635. Demographics, time to surgery, operative times, hospitalization time, and complications were collected...
August 17, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28807655/first-clinical-consensus-and-national-recommendations-on-tracheostomized-children-of-the-brazilian-academy-of-pediatric-otorhinolaryngology-abope-and-brazilian-society-of-pediatrics-sbp
#12
Melissa A G Avelino, Rebecca Maunsell, Fabiana Cardoso Pereira Valera, José Faibes Lubianca Neto, Cláudia Schweiger, Carolina Sponchiado Miura, Vitor Guo Chen, Dayse Manrique, Raquel Oliveira, Fabiano Gavazzoni, Isabela Furtado de Mendonça Picinin, Paulo Bittencourt, Paulo Camargos, Fernanda Peixoto, Marcelo Barciela Brandão, Tania Maria Sih, Wilma Terezinha Anselmo-Lima
INTRODUCTION: Tracheostomy is a procedure that can be performed in any age group, including children under 1year of age. Unfortunately health professionals in Brazil have great difficulty dealing with this condition due to the lack of standard care orientation. OBJECTIVE: This clinical consensus by Academia Brasileira de Otorrinolaringologia Pediátrica (ABOPe) and Sociedade Brasileira de Pediatria (SBP) aims to generate national recommendations on the care concerning tracheostomized children...
September 2017: Brazilian Journal of Otorhinolaryngology
https://www.readbyqxmd.com/read/28802395/changes-in-pediatric-tracheostomy-tubes-exposed-to-home-dishwashing
#13
David E Smolar, Brian Ho, Steven M Kent, C Anthony Hughes, Donald Mettenburg, Fredrick A Rueggeberg, Michael W Groves
OBJECTIVE: Determine the effects of household dishwashing on Tracheostomy Tube safety. INTRODUCTION: Tracheostomy tubes accumulate biofilms, which may limit their lifespan. Frequent cleaning of the tubes is a method for biofilm prevention. Cleaning practices vary widely. Some families prefer dishwashing of tubes, but its effects are currently unknown. We hypothesize that dishwashing has no significant effect on the physical properties of tracheostomy tubes and can be recommended as a safe way to clean tracheostomy tubes...
September 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28780390/a-12-year-experience-with-tracheostomy-for-neonates-and-infants-in-northern-taiwan-indications-hospital-courses-and-long-term-outcomes
#14
Chia-Huei Chen, Jui-Hsing Chang, Chyong-Hsin Hsu, Nan-Chang Chiu, Chun-Chin Peng, Wai-Tim Jim, Hung-Yang Chang, Kuo-Sheng Lee
BACKGROUND: Tracheostomy is a valuable procedure in infants and neonates with chronic respiratory failure or severe airway obstruction. The aim of this study is to identify the indication, hospital course, and long-term outcome in a cohort of infants who required tracheostomy in a neonatal and pediatric tertiary care center in northern Taiwan. METHODS: Medical records of infants, who underwent tracheostomy between January 2002 and December 2013, were retrospectively reviewed...
July 24, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28744846/extubation-failure-and-tracheostomy-placement-in-children-with-acute-neurocritical-illness
#15
Ellen C Cohn, Tammy S Robertson, Stacey A Scott, Andre M Finley, Rong Huang, Darryl K Miles
BACKGROUND: There is a lack of data describing the risk factors for extubation failure (EF) or tracheostomy placement in pediatric neurocritical care (NCC) patients. METHODS: A retrospective chart review of children admitted to the pediatric intensive care unit who were intubated for >24 h with an acute neurocritical illness and had an extubation attempt. Bivariate and multivariate statistical analysis was performed to determine significant associations of demographic, neurologic, pulmonary, and clinical variables with EF and tracheostomy placement...
July 25, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28743722/bedside-tracheostomy-on-pediatric-icu-subjects-supported-by-extracorporeal-membrane-oxygenation
#16
Stephanie P Schwartz, Desiree Bonadonna, Matthew G Hartwig, Ira M Cheifetz
BACKGROUND: Tracheostomy facilitates ambulatory extracorporeal membrane oxygenation (ECMO) as a bridge to recovery or lung transplantation in patients with respiratory failure, yet data on this procedure in this population are lacking. This report describes a series of pediatric ICU patients who had a bedside tracheostomy performed while being supported on ECMO and examines the potential impact of this procedure on active rehabilitation and sedation requirements. METHODS: This retrospective case series reviews all patients in the pediatric ICU who received a tracheostomy while being supported on ECMO at a single tertiary care center for the past 3 y...
July 25, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28740684/pediatric-airway-surgery
#17
REVIEW
Konrad Hoetzenecker, Thomas Schweiger, Doris Maria Denk-Linnert, Walter Klepetko
The management of pediatric airway pathology can be challenging and requires a dedicated team, consisting of thoracic surgeons, phoniatricians, logopedics, pediatricians and anesthetists. It necessitates a tailored treatment approach for each individual patient in order to address the minor variances that exist between cases. The majority of pediatric airway problems are a sequela of prematurity and prolonged post-partal intubation/tracheostomy. Surgical repair is often complicated by additional malformation or severe comorbidities...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28738121/incidence-risks-and-types-of-infections-in-pediatric-long-term-care-facilities
#18
Lisa Saiman, Philip Maykowski, Meghan Murray, Bevin Cohen, Natalie Neu, Haomioa Jia, Gordon Hutcheon, Edwin Simpser, Linda Mosiello, Luis Alba, Elaine Larson
Importance: The population of infants, children, and adolescents cared for at pediatric long-term care facilities is increasing in complexity and size and thus consumes substantial health care resources. Infections are a significant cause of morbidity and mortality in this population, but few recent data describe their incidence and effects. Objectives: To describe the types of infections diagnosed in residents of pediatric long-term care facilities, calculate infection rates, and identify risk factors for respiratory tract infections (RTIs)...
September 1, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28691936/national-variation-in-the-use-of-tracheostomy-in-patients-with-congenital-heart-disease
#19
Joyce T Johnson, Bradley S Marino, Darren Klugman, Pirouz Shamszad
OBJECTIVES: The postsurgical care of children with congenital heart disease may be complicated by the need for cardiorespiratory support, including tracheostomy. The variation of the use of tracheostomy across multiple pediatric cardiac surgical centers has not been defined. We describe multicenter variation in the use of tracheostomy in children undergoing congenital heart surgery. DESIGN: We retrospectively analyzed a multicenter cohort. SETTING: Pediatric Health Information Systems database retrospective cohort...
October 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28688574/clinical-and-bacteriological-differences-of-deep-neck-infection-in-pediatric-and-adult-patients-review-of-123-cases
#20
Yuichi Shimizu, Hiroshi Hidaka, Daiki Ozawa, Risako Kakuta, Kazuhiro Nomura, Hisakazu Yano, Ken-Ichi Watanabe, Yukio Katori
OBJECTIVES: Deep neck infections (DNIs) can lead to life-threatening disease. However, the detailed pathophysiology remains unclear due to its rarity and only a few reports have directly compared DNIs in children and adults. This study aimed to reveal the clinical differences between DNIs in children and adults. METHODS: We retrospectively reviewed 123 patients who suffered from DNIs at Tohoku University Hospital from August 2005 to July 2015. We extracted data on patient sex, age, antecedent illness, extension of infections, operative procedures, and bacteriology results...
August 2017: International Journal of Pediatric Otorhinolaryngology
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