Journal article
Care of pediatric tracheostomy in the immediate postoperative period and timing of first tube change
International journal of pediatric otorhinolaryngology, Vol.78(12), pp.2281-2285
12/2014
DOI: 10.1016/j.ijporl.2014.10.034
PMID: 25468464
Abstract
To analyze the safety of a standardized pediatric tracheostomy care protocol in the immediate postoperative period and its impact on tracheostomy related complications.
Retrospective case series.
Pediatric patients undergoing tracheotomy from February 2010-February 2014.
In 2012, a standardized protocol was established regarding postoperative pediatric tracheostomy care. This protocol included securing newly placed tracheostomy tubes using a foam strap with hook and loop fastener rather than twill ties, placing a fresh drain sponge around the tracheostomy tube daily, and performing the first tracheostomy tube change on postoperative day 3 or 4. Outcome measures included rate of skin breakdown and presence of a mature stoma allowing for a safe first tracheostomy tube change. Two types of tracheotomy were performed based on patient age: standard pediatric tracheotomy and adult-style tracheotomy with a Bjork flap. Patients were analyzed separately based on age and the type of tracheotomy performed.
Thirty-seven patients in the pre-protocol group and 35 in the post-protocol group were analyzed. The rate of skin breakdown was significantly lower in the post-protocol group (standard: p=0.0048; Bjork flap: p=0.0003). In the post-protocol group, all tube changes were safely accomplished on postoperative day three or four, and the stomas were deemed to be adequately matured to do so in all cases.
A standardized postoperative pediatric tracheostomy care protocol resulted in decreased rates of skin breakdown and demonstrated that pediatric tracheostomy tubes can be safely changed as early as 3 days postoperatively.
Details
- Title: Subtitle
- Care of pediatric tracheostomy in the immediate postoperative period and timing of first tube change
- Creators
- Dylan Lippert - University of Wisconsin–MadisonMatthew R Hoffman - University of Wisconsin School of Medicine and Public HealthPhat Dang - Rush University Medical CenterJ Scott McMurray - University of Wisconsin–MadisonDiane Heatley - University of Wisconsin–MadisonTony Kille - University of Wisconsin–Madison
- Resource Type
- Journal article
- Publication Details
- International journal of pediatric otorhinolaryngology, Vol.78(12), pp.2281-2285
- DOI
- 10.1016/j.ijporl.2014.10.034
- PMID
- 25468464
- ISSN
- 0165-5876
- eISSN
- 1872-8464
- Language
- English
- Date published
- 12/2014
- Academic Unit
- Otolaryngology
- Record Identifier
- 9984366380702771
Metrics
13 Record Views