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Pediatric tracheostomy: how real is decannulation?

Introduction: Tracheostomized children and their parents need special and multi-professional care, as morbimortality is high. Timing and prompt evaluation for decannulation are important for the development of the child. Aims: to analyze the outcomes of decannulation strategies in children submitted to tracheostomy at a tertiary university hospital in Brazil. Methods: The study was approved by the local ethic commission. In a retrospective analysis, the electronic patient charts of the pediatric population up to 17 years old, submitted to tracheostomy from 2015 to 2019, were included. We analyzed demographic data, comorbidities, time of follow-up, time for decannulation and mortality rate. Results: 64 children, 32 male, 4.11±5.49 mean age, were included. 19 suffered from genetic syndromes, 3 subglottic stenosis due to long-time intubation trauma. 25 (46.3%) died during the follow-up period, no death was related to the tracheostomy. 10 (15.6%) children were decannulated, within a timeframe varying from 3 to 40 months, mean time 23 months. 12 (22.2%) are still at follow-up, mean time of tracheostomy being 11 months, varying from 1 to 60 months. 17 (31,5%) are not treated at our hospital anymore and no data were available. Conclusions: Mortality of tracheostomized children is high due to their base disease. Decannulation is a long and difficult process. Children and parents need support to stimulate their development. Watters KF. Tracheostomy in Infants and Children. Respir Care. 2017 Jun;62(6):799-825. doi: 10.4187/respcare.05366.