Pediatric tracheostomy tube change

Abstract

Changing the tracheostomy tube in children is a key procedure, however, some of its aspects remain unclear.

Objective: To characterize the tracheostomy tube change in children from a long-stay health institution.

Patients and Method: Retrospective observational analytical study based on the 2-year clinical record of hospitalized children who underwent tracheostomy. The variables evaluated were the reason for tracheostomy tube change, size and brand of the tube, operator and participants (assistants/spectators) of the procedure, complications, and education.

Results: We analyzed 630 tracheostomy tube changes. The most frequent operators were relatives (33.7%). The main reason for the change was routine (83.3%). 10.7% of the changes presented some complications, where the most frequent was peristomal bleeding (47.37%) and the first failed attempt (34.21%). There was no association between the presence of balloon and complications (p = 0.24), nor with the use of Mechanical Ventilation (p = 0.8) or the operator (p = 0.74).

Conclusion: The routine change of the tracheostomy tube in children with prolonged artificial airway use is a safe procedure, which can be performed by both health professionals and properly trained family members.