Management and Strategy of Tracheostomy

The incidence of tracheostomy in children has increased over the last two decades. This is associated with the increased survival of premature infants and children with chronic neurological and respiratory morbidities, with the need for prolonged mechanical ventilation. Tracheostomy in a child is not without complications, those related to the presence of the tracheostomy tube itself, and also those related to the underlying complex medical conditions of the child. These factors, in addition to the specialized long-term care required to care for a child with a chronic tracheostomy, need to be considered prior to tracheostomy tube placement. The importance of preoperative counseling to the child and caregivers and the need for a multidisciplinary team approach in the management of a child with tracheostomy cannot be underestimated.