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Pediatric tracheostomy

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https://www.readbyqxmd.com/read/28525418/an-international-survey-on-ventilator-practices-among-extracorporeal-membrane-oxygenation-centers
#1
Christopher L Jenks, Jefferson Tweed, Kristin H Gigli, Ramgopal Venkataraman, Lakshmi Raman
Although the optimal ventilation strategy is unknown for patients placed on extracorporeal support, there are increasing reports of extubation being used. Our objective is to describe the change in ventilation strategies and use of tracheostomy and bronchoscopy practices among extracorporeal membrane oxygenation (ECMO) centers across the world. A descriptive, cross-sectional 22 item survey of neonatal, pediatric, and adult ECMO centers was used to evaluate ventilator strategies, extubation, bronchoscopy, and tracheostomy practices...
May 18, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28513521/otorhinolaryngological-emergencies-in-a-tertiary-hospital-in-port-harcourt
#2
U M Ibekwe
BACKGROUND: Emergencies are not uncommon in a typical otorhinolaryngological (ORL) clinic. The knowledge of the profile and prevalence of these emergencies will go a long way in helping to equip as well as aid proper and prompt management of these conditions so as to reduce their morbidity and mortality. PATIENTS AND METHODS: A descriptive retrospective 8 years review of all patients that presented to the ENT Surgery Department from January 2004 to December 2012...
May 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/28504000/factors-associated-with-successful-decannulation-in-pediatric-tracheostomy-patients
#3
Nozomi Takahashi, Kenichi Takano, Hiroaki Mitsuzawa, Maokoto Kurose, Tetsuo Himi
OBJECTIVES: To investigate the outcome of pediatric tracheostomy and identify predictive factors for successful decannulation. METHODS: We performed a retrospective chart review of a series of 42 consecutive patients of less than 24 months of age who underwent a tracheostomy between 2012 and 2015. RESULTS: Successful decannulation was achieved in 11 patients (26%). Thirty-one patients (74%) remained tracheostomy-dependent. Of the 11 patients who were successfully decannulated, 10 (91%) had only structural disorders and nine (82%) were able to walk unassisted; importantly, nine (82%) were able to swallow following decannulation...
May 14, 2017: Acta Oto-laryngologica
https://www.readbyqxmd.com/read/28483242/prevention-of-post-operative-pediatric-tracheotomy-wounds-a-multidisciplinary-team-approach
#4
Timothy P McEvoy, Nolan B Seim, Abdullah Aljasser, Charles A Elmaraghy, Brenda Ruth, Leslie Justice, Sarah Begue, Kris R Jatana
OBJECTIVE: Tracheotomy-related pressure wounds have been reported as high as 29%. All advanced stage (stage 3 or 4) wounds are reported by hospitals, and CMS will no longer reimburse healthcare costs to manage them. We present the results of an intensive, multidisciplinary wound prevention strategy starting in the operating room at the time of tracheotomy placement. METHODS: Prospective analysis of a tracheostomy wound care protocol at an academic, tertiary-care pediatric hospital from September 2012 to February 2016...
June 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28483222/endoscopic-management-of-bilateral-vocal-fold-paralysis-in-newborns-and-infants
#5
Sahba Sedaghat, Mario Tapia, Felipe Fredes, Pablo Rojas
INTRODUCTION: Bilateral vocal cord paralysis in adducted position (BVCPAd) is a severe cause of airway obstruction and usually debuts with stridor and airway distress necessitating immediate intervention. Tracheostomy has long been the gold standard for treating this condition, but has significant associated morbidity and mortality in pediatric patients. New conservative procedures have emerged to treat this condition thus avoiding tracheostomy, like endoscopic anterior and posterior cricoid split (EAPCS)...
June 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28483219/laryngotracheal-anomalies-and-airway-fluoroscopy-in-infants
#6
Amal Isaiah, Kevin D Pereira
OBJECTIVES: The role of airway fluoroscopy in the diagnosis of laryngotracheal anomalies in infants is controversial. We aimed to (i) compare airway fluoroscopic characteristics with endoscopic findings in infants presenting for evaluation of upper airway obstruction and (ii) assess the as low as is reasonably achievable (ALARA) status for airway fluoroscopy as an initial diagnostic test in suspected laryngotracheal anomalies. MATERIALS AND METHODS: We performed a retrospective review of children who underwent fluoroscopy and endoscopic evaluation of the airway in the operating room for suspected laryngotracheal anatomic abnormalities...
June 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28483217/routine-airway-surveillance-in-pediatric-tracheostomy-patients
#7
REVIEW
Ozgul Gergin, Eelam Adil, Kosuke Kawai, Karen Watters, Ethan Moritz, Reza Rahbar
OBJECTIVES: The aim of this study is to review airway findings in children with tracheostomies who underwent surveillance direct laryngoscopy and bronchoscopy (DLB) to determine the yield of routine airway evaluation in these patients. STUDY DESIGN: Retrospective chart review at tertiary referral children's hospital. METHODS: A retrospective chart review was conducted of all of the children with tracheostomies who underwent DLB after tracheostomy between 1984 and 2015...
June 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28468263/an-evaluation-of-a-continuing-education-program-for-family-caregivers-of-ventilator-dependent-children-with-spinal-muscular-atrophy-sma
#8
Deborah S Boroughs
Until 25 years ago, there were limited options for long-term mechanical ventilation of children, and the majority of children were cared for in hospitals. However, with improving technology, the pediatric intensive care unit has moved from the hospital to a home setting, as children with increasingly complex healthcare needs are now often cared for by family members. One of the most complex care conditions involves ventilator and tracheostomy support. Advanced respiratory technologies that augment natural respiratory function prolong the lives of children with respiratory compromise; however, this care often comes with serious risks, including respiratory muscle impairment, respiratory failure, and chronic pulmonary disease...
April 29, 2017: Children
https://www.readbyqxmd.com/read/28468151/tracheal-cartilaginous-sleeve-in-syndromic-craniosynostosis-an-underrecognized-source-of-significant-morbidity-and-mortality
#9
Brent B Pickrell, Jesse D Meaike, Karina T Cañadas, Binoy M Chandy, Edward P Buchanan
Tracheal cartilaginous sleeve (TCS) is a rare and previously unrecognized source of morbidity and mortality in patients with certain craniosynostosis syndromes. There is a paucity of reporting on this airway anomaly, and the true incidence of TCS is largely unknown. The purpose of this study was to investigate the incidence of TCS among patients with syndromic craniosynostosis at our institution. Patients with syndromic craniosynostosis who underwent direct bronchoscopy and laryngoscopy were evaluated retrospectively by pediatric otolaryngologists for the presence of TCS and associated anomalies...
May 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28460700/airways-and-injuries-protecting-our-pediatric-patients-from-respiratory-device-related-pressure-injuries
#10
REVIEW
Laura J Miske, Molly Stetzer, Melissa Garcia, Judith J Stellar
Pressure injury prevention is required in all health care environments. Respiratory technology includes invasive and noninvasive positive pressure ventilation methods of support and life-saving equipment. Pressure injury can occur from tracheostomy tubes and their securement devices, or use of noninvasive positive pressure ventilation interfaces or the head gear. Methods instituted to decrease hospital-acquired pressure injury related to noninvasive positive pressure ventilation and tracheostomy securement devices are discussed...
June 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28460695/reducing-fresh-tracheostomy-decannulations-following-implementation-of-a-fresh-tracheostomy-guideline
#11
REVIEW
Kristen Hood, Brennan Lewis, Cindy Darnell Bowens
Pediatric patients undergoing tracheostomy placement are often medically fragile with multiple comorbidities. The complexity of these patients partnered with the risks of a newly placed tracheostomy necessitates a clear understanding of patient management and clinical competence. At our institution, a quality improvement initiative was formed with a focus on increasing the safety of these patients by developing a postoperative care guideline.
June 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28460120/post-neonatal-tetanus-in-a-picu-of-a-developing-economy-intensive-care-needs-outcome-and-predictors-of-mortality
#12
Suresh Kumar Angurana, Muralidharan Jayashree, Arun Bansal, Sunit Singhi, Karthi Nallasamy
Objectives: To evaluate pediatric intensive care unit (PICU) needs, outcome and predictors of mortality in post-neonatal tetanus. Materials and methods: Review of 30 consecutive post-neonatal tetanus cases aged 1 months to 12 years admitted to a PICU in north India over a period of 10 years (January 2006 to December 2015). Results: Chronic suppurative otitis media was the commonest portal of entry. All received tetanus toxoid, human tetanus immunoglobulin (HTIG) and appropriate antibiotics; 7 (23...
April 27, 2017: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/28439690/association-of-endotracheal-tube-repositioning-and-acute-laryngeal-lesions-during-mechanical-ventilation-in-children
#13
Denise Manica, Catia de Souza Saleh Netto, Cláudia Schweiger, Leo Sekine, Larissa Valency Enéas, Denise Rotta Pereira, Gabriel Kuhl, Paulo Roberto Antonacci Carvalho, Paulo José Cauduro Marostica
The objective of this study is to determine the incidence of post-extubation acute laryngeal lesions in a pediatric intensive care unit (PICU) and potential risk factors. Children, aged 28 days to 5 years, admitted to the PICU who required endotracheal intubation for at least 24 h were enrolled. Exclusion criteria were a previous intubation, history of laryngeal disease, current or past tracheostomy, the presence of craniofacial malformations and patients considered on palliative care. All patients underwent flexible fiber-optic laryngoscopy (FFL) not later than 8 h after extubation...
April 24, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28419061/functional-status-of-neonatal-and-pediatric-patients-after-extracorporeal-membrane-oxygenation
#14
Katherine Cashen, Ron Reeder, Heidi J Dalton, Robert A Berg, Thomas P Shanley, Christopher J L Newth, Murray M Pollack, David Wessel, Joseph Carcillo, Rick Harrison, J Michael Dean, Tammara Jenkins, Kathleen L Meert
OBJECTIVES: To describe functional status at hospital discharge for neonatal and pediatric patients treated with extracorporeal membrane oxygenation, and identify factors associated with functional status and mortality. DESIGN: Secondary analysis of observational data collected by the Collaborative Pediatric Critical Care Research Network between December 2012 and September 2014. SETTING: Eight hospitals affiliated with the Collaborative Pediatric Critical Care Research Network...
April 17, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28417683/tracheostomy-for-severe-pediatric-obstructive-sleep-apnea-indications-and-outcomes
#15
Christopher J Rizzi, Julian D Amin, Amal Isaiah, Tulio A Valdez, Anita Jeyakumar, Suzanne E Smart, Kevin D Pereira
Objectives (1) To describe characteristics of pediatric patients undergoing tracheostomy for obstructive sleep apnea (OSA). (2) To highlight perioperative events and outcomes of the procedure. Study Design Case series with chart review. Setting Four tertiary care academic children's hospitals. Subjects and Methods Twenty-nine children aged <18 years from January 1, 2010, to December 31, 2015, who underwent tracheostomy for severe OSA, defined as an apnea-hypopnea index (AHI) >10, were included in the study...
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28358176/early-versus-late-tracheostomy-in-pediatric-intensive-care-unit-does-it-matter-a-6-year-experience
#16
Alessandro Pizza, Enzo Picconi, Marco Piastra, Orazio Genovese, Daniele G Biasucci, Giorgio Conti
BACKGROUND: The aim of this study is to examine the clinical data of children who underwent tracheostomy during their stay in Pediatric Intensive Care Unit (PICU), in order to describe the relationship between the timing of tracheostomy, the length of PICU stay and the occurrence of Ventilator-Associated Pneumonia (VAP). METHODS: This is a retrospective cohort study that collects all patients undergoing tracheostomy during their PICU stay over a six year period...
March 28, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28350680/airway-and-feeding-outcomes-of-mandibular-distraction-tongue-lip-adhesion-and-conservative-management-in-pierre-robin-sequence-a-prospective-study
#17
Ibrahim Khansa, Courtney Hall, Lauren L Madhoun, Mark Splaingard, Adriane Baylis, Richard E Kirschner, Gregory D Pearson
BACKGROUND: Pierre Robin sequence is characterized by mandibular retrognathia and glossoptosis resulting in airway obstruction and feeding difficulties. When conservative management fails, mandibular distraction osteogenesis or tongue-lip adhesion may be required to avoid tracheostomy. The authors' goal was to prospectively evaluate the airway and feeding outcomes of their comprehensive approach to Pierre Robin sequence, which includes conservative management, mandibular distraction osteogenesis, and tongue-lip adhesion...
April 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28341025/standardizing-care-and-parental-training-to-improve-training-duration-referral-frequency-and-length-of-stay-our-quality-improvement-project-experience
#18
Concettina Tina Tolomeo, Nili E Major, Mary V Szondy, Alia Bazzy-Asaad
OBJECTIVES: At our institution, there is a six bed Pediatric Respiratory Care Unit for technology dependent infants and children with a tracheostomy tube. A lack of consistency in patient care and parent/guardian education prompted our group to critically evaluate the services we provided by revisiting our teaching protocol and instituting a new model of care in the Unit. The aims of this quality improvement (QI) project were to standardize care and skills proficiency training to parents of infants with a tracheostomy tube in preparation for discharge to home...
January 2017: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/28271539/endoscopic-anterior-posterior-cricoid-split-for-pediatric-bilateral-vocal-fold-paralysis
#19
Michael J Rutter, Catherine K Hart, Alessandro de Alarcon, Sam Daniel, Sanjay R Parikh, Karthik Balakrishnan, Derek Lam, Kaalan Johnson, Douglas R Sidell
OBJECTIVES/HYPOTHESIS: Children with bilateral true vocal fold immobility (BTVFI) may present with significant airway distress necessitating tracheostomy. The objective of this study was to review our preliminary experience with the anterior-posterior cricoid split (APCS), an endoscopic intervention used as an alternative to tracheostomy in children with BTVFI. STUDY DESIGN: Multicenter review. METHODS: A review of patients undergoing endoscopic APCS for BTVFI at four institutions was performed...
March 8, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28263440/a-decade-of-pediatric-tracheostomies-indications-outcomes-and-long-term-prognosis
#20
Mona L McPherson, Lara Shekerdemian, Michelle Goldsworthy, Charles G Minard, Cynthia S Nelson, Fernando Stein, Jeanine M Graf
OBJECTIVE: To define the mortality and long-term outcomes of children undergoing tracheostomy. DESIGN: Retrospective chart and Texas Department of Health Bureau of Vital Statistics review of patients admitted to a Pediatric Intensive Care Unit who underwent a tracheostomy between 2001 and 2011. Mortality and decannulation rates were compared based on tracheostomy indication and age. SUBJECTS: A total of 426 patients admitted to a Pediatric Intensive Care Unit in a large tertiary children's hospital...
March 6, 2017: Pediatric Pulmonology
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