Basics pp 197-213 | Cite as

Tracheotomy in Children

  • Giuliana Rizzo
  • Paolo Murabito
  • Francesca Rubulotta
  • Carmela Cutuli
  • Massimiliano Sorbello
  • Marinella Astuto
Part of the Anaesthesia, Intensive Care and Pain in Neonates and Children book series (AICPNC)


Tracheotomy in children is a relatively uncommon and high-skill procedure, which is generally performed if ventilator support is required for months to years [1, 2]. Although the procedure is difficult and challenging to perform, it is truly rewarding to access a safe and protected airway. However, the issue remains complex from the psychosocial point of view, for both the growing child and the caregivers and family members [3].


Tracheal Stenosis Innominate Artery Percutaneous Dilatational Tracheotomy Medical Emergency Team Percutaneous Technique 


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  1. 1.
    Lewis CH, Carron JD, Perkins JA et al (2003) Tracheotomy in pediatric patients. A national perspective. Arch Otolaryngol Head Neck Surg 129:523–529CrossRefPubMedGoogle Scholar
  2. 2.
    Bigler J, Holinger P, Johnson K (1954) Tracheotomy in infancy. Pediatrics 13:5Google Scholar
  3. 3.
    Trachsel D, Hammer J (2006) Indications for tracheotomy in children. Paediatr Respir Rev 7:162–168CrossRefPubMedGoogle Scholar
  4. 4.
    Davis GM (2006) Tracheostomy in children. Paediatr Respir Rev 7[Suppl 1]:S206–S209CrossRefPubMedGoogle Scholar
  5. 5.
    Cochrane LA, Bailey CM (2006) Surgical aspects of tracheotomy in children. Paediatr Respir Rev 7:169–174CrossRefPubMedGoogle Scholar
  6. 6.
    Hotaling AJ, Robbins WK, Madgy DN et al (1992) Pediatric tracheotomy: a review of technique. Am J Otolaryngol 13:115–119CrossRefPubMedGoogle Scholar
  7. 7.
    Greenberg JS, Sulek M, de Jong A et al (2001) The role of postoperative chest radiography in pediatric tracheotomy. Int J Pediatr Otorhinolaryngol 60:41–47CrossRefPubMedGoogle Scholar
  8. 8.
    Scott CJ, Darowski M, Crabbe DC (1998) Complications of percutaneous dilatational tracheostomy in children. Anaesthesia 53:477–480CrossRefPubMedGoogle Scholar
  9. 9.
    Van Heurn LW, Theunissen PH, Ramsay G et al (1996) Pathological changes of the trachea after percutaneous dilational tracheotomy. Chest 109:1466–1469CrossRefPubMedGoogle Scholar
  10. 10.
    Russel C, Matta B (eds) (2004) Tracheotomy. A multiprofessional handbook. Greenwich Medical Media, LondonGoogle Scholar
  11. 11.
    Koltai PJ (1998) Starplasty, a new technique of pediatric tracheotomy. Arch Otolaryngol Head Neck Surg 124:1105–1111PubMedGoogle Scholar
  12. 12.
    Eliashar R, Gross M, Attal P et al (2004) “Starplasty” prevents tracheotomy complications in infants. Int J Pediatr Otorhinolaryngol 68:325–329CrossRefPubMedGoogle Scholar
  13. 13.
    Solares CA, Krakovitz P, Hirose K (2004) Starplasty: revisiting a pediatric tracheotomy technique. Otolaryngol Head Neck Surg 131:717–722CrossRefPubMedGoogle Scholar
  14. 14.
    Behl S, Watt JWH (2005) Prediction of tracheotomy tube size for paediatric long-term ventilation: an audit of children with spinal cord injury. Br J Anaesth 94:88–91CrossRefPubMedGoogle Scholar
  15. 15.
    Penlington GN (1974) Endotracheal tube sizes for children. Anaesthesia 29:494–495CrossRefPubMedGoogle Scholar
  16. 16.
    Hardee PS, Cashman M (2003) Ultrasound imaging in the preoperative estimation of the size of tracheotomy tube required in specialised operations in children. Br J Oral Maxillofac Surg 41:312–316CrossRefPubMedGoogle Scholar
  17. 17.
    Gullo A, Sorbello M, Frova G (2007) Percutaneous versus surgical tracheotomy: an unfinished symphony. Crit Care Med 35:682–683CrossRefPubMedGoogle Scholar
  18. 18.
    Zawadzka-Glosa L, Rawiczb M, Chmielik M et al (2004) Percutaneous tracheotomy in children. Int J Pediatr Otorhinolaryngol 68:1387–1390CrossRefGoogle Scholar
  19. 19.
    Sheldon CH, Pudenz RH, Freshwater DB et al (1955) A new method for tracheotomy. J Neurosurg 12:428–431CrossRefGoogle Scholar
  20. 20.
    Ciaglia P, Firsching R, Syniec C (1985) Elective percutaneous dilatational tracheotomy: a new simple bedside procedure; preliminary report. Chest 87:715–719CrossRefPubMedGoogle Scholar
  21. 21.
    Fantoni A, Ripamonti D (2002) Tracheotomy in pediatrics patients. Minerva Anestesiol 68:433–442PubMedGoogle Scholar
  22. 22.
    Toursarkissian B, Fowler CL, Zweng TN et al (1994) Percutaneous dilatational tracheotomy in children and teenagers. J Pediatr Surg 29:1421–1424CrossRefPubMedGoogle Scholar
  23. 23.
    Silvia Bárbara C, Rodríguez Núñez A, López Franco M et al (2005) Traqueostomía percutánea bajo control endoscópico en adolescentes. An Pediatr (Barc) 63:160–163CrossRefGoogle Scholar
  24. 24.
    Walz MK (1997) Percutaneous dilational tracheotomy: method indications, contraindications and results. Curr Opin Anesthesiol 10:101–105CrossRefGoogle Scholar
  25. 25.
    Polderman KH, Spijkstra JJ, De Bree R et al (2003) Percutaneous dilatational tracheotomy in the ICU. Optimal organization, low complication rates, and description of a new complication. Chest 123:1595–1602CrossRefPubMedGoogle Scholar
  26. 26.
    Kremer B, Botos-Kremer AI, Eckel HE (2002) Indications, complications, and surgical techniques for pediatric tracheotomies: an update. J Pediatr Surg 37:1556–1562CrossRefPubMedGoogle Scholar
  27. 27.
    Pinto JM, Ansley J, Baroody FM (2001) Lack of utility of postoperative chest radiograph in pediatric tracheotomy. Otolaryngol Head Neck Surg 125:241–244CrossRefPubMedGoogle Scholar
  28. 28.
    Hamburger MD, Wold JS, Berry JA et al (2000) Appropriateness of routine postoperative chest radiography after tracheotomy. Arch Otolaryngol Head Neck Surg 126:649–651PubMedGoogle Scholar
  29. 29.
    Ward RF, Jones J, Carew JF (1995) Current trends in pediatric tracheotomy. Int J Pediatr Otorhinolaryngol 33:233–239CrossRefGoogle Scholar
  30. 30.
    Goldenberg D, Ari EG, Golz A et al (2000) Tracheotomy complications: a retrospective study of 1130 cases. Otolaryngol Head Neck Surg 123:495–500CrossRefPubMedGoogle Scholar
  31. 31.
    Alladi A, Rao S, Das K et al (2004) Pediatric tracheotomy: a 13-year experience. Pediatr Surg Int 20:695–698CrossRefPubMedGoogle Scholar
  32. 32.
    Carr MM, Poje CP, Kingston L et al (2001) Complications in pediatric tracheotomies. Laryngoscope 111:1925–1928CrossRefPubMedGoogle Scholar
  33. 33.
    Lee W, Koltai P, Harrison M et al (2002) Indications for tracheotomy in the pediatric intensive care unit population. A pilot study. Arch Otolaryngol Head Neck Surg 128:1249–1252PubMedGoogle Scholar
  34. 34.
    Wetmore RF, Marsh RR, Thompson ME et al (1999) Pediatric tracheotomy: a changing procedure? Arch Otolaryngol Head Neck Surg 108:695–699Google Scholar
  35. 35.
    Carron JD, Derkay CS, Strope GL et al (2000) Pediatric tracheotomies: changing indications and outcomes. Laryngoscope 110:1099–1104CrossRefPubMedGoogle Scholar
  36. 36.
    Gaudet PT, Peerless A, Sasaki CT et al (1978) Pediatric tracheotomy and associated complications. Laryngoscope 88:1633–1641CrossRefPubMedGoogle Scholar
  37. 37.
    Citta-Pietrolungo TJ, Alexander MA, Cook SP et al (1993) Complications of tracheotomy and decannulation in pediatric and young patients with traumatic brain injury. Arch Phys Med Rehabil 74:905–909PubMedGoogle Scholar
  38. 38.
    Gianoli JG, Miller RH, Guarisco JL (1999) Tracheotomy in the first year of life. Ann Otol Rhinol Laryngol 99:896–901Google Scholar
  39. 39.
    Pereira KD, MacGregor AR, McDuffie CM et al (2003) Tracheotomy in preterm infants. Current trends. Arch Otolaryngol Head Neck Surg 129:1268–1271CrossRefPubMedGoogle Scholar
  40. 40.
    Kenna MA, Reilly JS, Stool SE (1987) Tracheotomy in the preterm infant. Ann Otol Rhinol Laryngol 96:68–71PubMedGoogle Scholar
  41. 41.
    Rocha EP, Dias MD, Szajmbok FE et al (2000) Tracheostomy in children: there is a place for acceptable risk. J Trauma 49:483–485CrossRefPubMedGoogle Scholar
  42. 42.
    Simma B, Spehler D, Burger R (1994) Tracheotomy in children. Eur J Pediatr 153:291–296CrossRefPubMedGoogle Scholar
  43. 43.
    Gianoli G, Miller R, Guarisco J (1990) Tracheotomy in the first year of life. Ann Otol Rhinol 92:398–400Google Scholar
  44. 44.
    Birman C, Beckenham E (1998) Acquired tracheo-esophageal fistula in the pediatric population. Int J Pediatr Otorhinolaryngol 44:109–113CrossRefPubMedGoogle Scholar
  45. 45.
    Duncan BW, Howell LJ, deLorimier AA et al (1992) Tracheotomy in children with emphasis on home care. J Pediatr Surg 27:432–435CrossRefPubMedGoogle Scholar
  46. 46.
    Sorbello M, Guarino A, Morello G (2007) Practical aspects for managing extubation of the difficult airway. In: Gullo A (ed) Anaesthesia Pain Intensive Care and Emergency Medicine — A.P.I.C.E. Proceedings of the 22nd Postgraduate Course in Critical Care Medicine, Venice-Mestre, 9–11 November 2007. Springer Verlag Italia, pp 81–92Google Scholar
  47. 47.
    Prescott CA, Vanlierde MJ (1989) Tracheotomy in children — The Red Cross War Memorial Children’s Hospital experience 1980–1985. Int J Pediatr Otorhinolaryngol 17:97–107CrossRefPubMedGoogle Scholar
  48. 48.
    Arcand P, Granger J (1988) Pediatric tracheotomies: changing trends. J Otolaryngol 17:121–125PubMedGoogle Scholar
  49. 49.
    Line WS, Hawkins DB, Kahlstrom EJ et al (1986) Tracheotomy in infants and young children: the changing perspective 1970–1985. Laryngoscope 96:510–515CrossRefPubMedGoogle Scholar
  50. 50.
    Wetmore RF, Handler SD, Potsic WP (1982) Pediatric tracheotomy. Experience during the past decade. Ann Otol Rhinol Laryngol 91:628–632PubMedGoogle Scholar
  51. 51.
    Oberwaldner B, Eber E (2006) Tracheotomy care in the home. Paediatr Respir Rev 7:185–190CrossRefPubMedGoogle Scholar
  52. 52.
    Messineo A, Giusti F, Narne S et al (1995) The safety of home tracheotomy care for children. J Pediatr Surg 30:1246–1248CrossRefPubMedGoogle Scholar
  53. 53.
    Buzz-Kelly L, Gordin P (1993) Teaching CPR to parents of children with tracheotomies. MCN Am J Matern Child Nurs 18:158–163CrossRefPubMedGoogle Scholar
  54. 54.
    Bryant K, Davis C, Lagrone C (1997) Streamline discharge planning for the child with a new tracheotomy. J Pediatr Nurs 12:191–192CrossRefPubMedGoogle Scholar
  55. 55.
    Carnevale FA, Alexander E, Davis M et al (2006) Daily living with distress and enrichment: the moral experience of families with ventilator assisted children at home. Pediatrics 117:e48–e60CrossRefPubMedGoogle Scholar
  56. 56.
    Lewarski JS (2005) Long-term care of the patient with a tracheotomy. Respir Care 50:534–537PubMedGoogle Scholar
  57. 57.
    Rubulotta F, Pinsky MR (2006) Second International Conference on Rapid Response System and Medical Emergency Team, 28–30 June 2006, Pittsburgh, PA, USA. Crit Care 10:319CrossRefPubMedGoogle Scholar
  58. 58.
    De Vita MA, Bellomo R, Hillman K et al (2006) Findings of the first consensus conference on medical emergency teams. Crit Care Med 34:2463–2478CrossRefGoogle Scholar
  59. 59.
    Tobin AE, Santamaria JD (2008) An intensivist-led tracheotomy review team is associated with shorter decannulation time and length of stay: a prospective cohort study. Crit Care 12:R48CrossRefPubMedGoogle Scholar
  60. 60.
    Price B (1992) Living with altered body image: the cancer experience. Br J Nurs 1:641–645PubMedGoogle Scholar
  61. 61.
    Dropkin MJ (1989) Coping with disfigurement and dysfunction after head and neck cancer surgery: a conceptual framework. Semin Oncol Nurs 5:213–219CrossRefPubMedGoogle Scholar
  62. 62.
    Seay SJ, Gay SL (1997) Problem in tracheostomy patient care: recognizing the patient with a displaced tracheostomy tube. ORL Head Neck Nurs 15:10–11PubMedGoogle Scholar
  63. 63.
    Frova G, Guarino A, Sorbello M et al (2006) Recommendations for airway control and difficult airway management in paediatric patients. Minerva Anestesiol 72:723–748PubMedGoogle Scholar

Copyright information

© Springer-Verlag Italia 2009

Authors and Affiliations

  • Giuliana Rizzo
    • 1
    • 2
  • Paolo Murabito
    • 3
  • Francesca Rubulotta
    • 3
  • Carmela Cutuli
    • 3
  • Massimiliano Sorbello
    • 3
  • Marinella Astuto
    • 1
  1. 1.Department of Anesthesia and Intensive Care, Pediatric Anesthesia and Intensive Care SectionCatania University HospitalCataniaItaly
  2. 2.Department of Anesthesia and Palliative Care, Montreal Children’s Hospital“McGill” UniversityMontrealCanada
  3. 3.Department of Anesthesia and Intensive Care, Postgraduate School of Anesthesia and Intensive CareCatania University HospitalCataniaItaly

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