Approximately half of all pediatric tracheostomies are performed in infants younger than 1 year. Most tracheostomies in patients in the NICU are performed in cases of chronic respiratory failure requiring prolonged mechanical ventilation or upper airway obstruction. With improvements in ventilation and management of long-term intubation, indications for tracheostomy and perioperative management in this population continue to evolve. Evidence-based protocols to guide routine postoperative care, prevent and manage tracheostomy emergencies including accidental decannulation and tube obstruction, and attempt elective decannulation are sparse. Clinician awareness of safe tracheostomy practices and larger, prospective studies in infants are needed to improve clinical care of this vulnerable population.
Tracheostomy in Infants in the Neonatal Intensive Care Unit
Drs Chang and Sidell have disclosed no financial relationships relevant to this article. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.
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Julia Chang, Douglas R. Sidell; Tracheostomy in Infants in the Neonatal Intensive Care Unit. Neoreviews May 2020; 21 (5): e323–e334. https://doi.org/10.1542/neo.21-5-e323
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