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Changing indications for paediatric tracheostomy and the role of a multidisciplinary tracheostomy clinic

  • M M C Yaneza (a1), H P James (a2), P Davies (a3), S Harrison (a1), L McAlorum (a4), W A Clement (a1) and H Kubba (a1)...

Abstract

Objective:

This paper presents our experience of managing children with a tracheostomy in a multidisciplinary team clinic consisting of an ENT consultant, paediatric respiratory consultant, a nurse specialist, and speech and language therapist.

Method:

A retrospective case note review was conducted of all children seen in the multidisciplinary team tracheostomy clinic (at a tertiary paediatric hospital) between February 2009 and September 2014.

Results:

Ninety-seven patients were examined. The most common indications for tracheostomy were: lower airway and respiratory problems (66 per cent), upper airway obstruction (64 per cent), and neurodevelopmental problems (60.8 per cent).

Conclusion:

Children with a tracheostomy are a diverse group of patients. The most common indications for paediatric tracheostomy have changed from infective causes to airway obstruction and anomalies, long-term ventilation requirement, and underlying neuromuscular or respiratory problems. Our unified approach empowers the carers and patient, as a home management plan, long-term plan and goals are generated at the end of each appointment.

Copyright

Corresponding author

Address for correspondence: Miss M M C Yaneza c/o Mr Haytham Kubba, Department of Otolaryngology, The Royal Hospital for Sick Children, Yorkhill, Glasgow G3 8SJ, Scotland, UK Fax: 0141 201 0865 E-mail: maymcyaneza@doctors.org.uk

References

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1Newlands, WJ, McKerrow, WS. Paediatric tracheostomy. Fifty-seven operations on fifty-three children. J Laryngol Otol 1987;101:929–35
2Hadfield, PJ, Lloyd-Faulconbridge, RV, Almeyda, J, Albert, DM, Bailey, CM. The changing indications for paediatric tracheostomy. Int J Pediatr Otorhinolaryngol 2003;67:710
3Donnelly, MJ, Lacey, PD, Maguire, AJ. A twenty year (1971–1990) review of tracheostomies in a major paediatric hospital. Int J Pediatr Otorhinolaryngol 1996;35:19
4Zenk, J, Fyrmpas, G, Zimmermann, T, Koch, M, Constantinidis, J, Iro, H. Tracheostomy in young patients: indications and long-term outcome. Eur Arch Otorhinolaryngol 2009;266:705–11
5Cetto, R, Arora, A, Hettige, R, Nel, M, Benjamin, L, Gomez, CM et al. Improving tracheostomy care: a prospective study of the multidisciplinary approach. Clin Otolaryngol 2011;36:482–8
6Garrubba, M, Turner, T, Grieveson, C. Multidisciplinary care for tracheostomy patients: a systematic review. Crit Care 2009;13:R177
7Yu, M. Tracheostomy patients on the ward: multiple benefits from a multidisciplinary team? Crit Care 2010;14:109

Keywords

Changing indications for paediatric tracheostomy and the role of a multidisciplinary tracheostomy clinic

  • M M C Yaneza (a1), H P James (a2), P Davies (a3), S Harrison (a1), L McAlorum (a4), W A Clement (a1) and H Kubba (a1)...

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