Tracheotomy in children – indications and complications

Lidia Zawadzka-Głos, Mieczysław Chmielik

Summary
Tracheostomy is a life-saving procedure when performed with an appropriate indication and surgical technique. There is a limited indication for tracheostomy procedures in paediatric surgery. It is rarely applied to the paediatric patient because they can be kept intubated for a longer period compared to adults. Indications for tracheostomy are prolonged intubation, subglotic stenosis, general body trauma, tracheomalasia, cervical tumour pressing the trachea and larynx, congenital diseases of the larynx, burn injuries of the trachea, and foreign body aspiration. In the last decade the number of cases with tracheotomy increased due to the development of new intensive care units, the use of mechanical ventilation, and the increasing number of patients needing prolonged ventilation support. Tracheotomy in children has been associated with significant operative and post-operative complications. When long-term tracheotomy is needed, parent education, together with special equipment and environment may allow the return of the tracheotomised child to home in secure conditions.

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