Abstract |
Vaccination programs, improvements in material engineering and anaesthetic skills have dramatically reduced the number of emergency tracheostomies performed for acute upper airway obstruction. Today, the indication to tracheotomise a child is generally ruled by the anticipation of long-term (cardio)respiratory compromise due to chronic ventilatory or, more rarely, cardiac insufficiency, or by the presence of a fixed upper airway obstruction that is unlikely to resolve for a significant period of time. As many of the younger candidates for tracheostomy have complex medical conditions, the indication for this intervention is often complicated by ethical, funding and socio-economic concerns that necessitate a multidisciplinary approach. Unfortunately, these considerations are frequently not made until the first catastrophe has occurred, even in those patients in whom imminent cardiorespiratory failure has been foreseeable. Non-invasive ventilation via a face mask and newer developments such as the in-exsufflator device have gained importance as an alternative to tracheostomy in selected patients.
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Authors | Daniel Trachsel, Jürg Hammer |
Journal | Paediatric respiratory reviews
(Paediatr Respir Rev)
Vol. 7
Issue 3
Pg. 162-8
(Sep 2006)
ISSN: 1526-0542 [Print] England |
PMID | 16938637
(Publication Type: Journal Article, Review)
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Topics |
- Airway Obstruction
(therapy)
- Child
- Child, Preschool
- Guidelines as Topic
- Humans
- Infant
- Respiration, Artificial
- Respiratory Insufficiency
(therapy)
- Trachea
(pathology)
- Tracheostomy
(methods, standards)
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