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Eur Ann Otorhinolaryngol Head Neck Dis 2020 May 23. Epub 2020 May 23.

Department of Pediatric Maxillofacial and Plastic Surgery, Head and Neck Surgery, Necker-Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Paris University, Paris, France.

During the COVID-19 outbreak, personal protective equipment is widely used to limit infection of caregivers. Innovative solutions have been described to overcome supply shortage. The adaptation of the EasyBreath® surface snorkeling mask by the Prakash team has benefited from outstanding media coverage. Read More

Int J Pediatr Otorhinolaryngol 2020 May 19;135:110122. Epub 2020 May 19.

Division of Otolaryngology, Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA, 19104, USA; Department of Otorhinolaryngology-Head and Neck Surgery, Perelman School of Medicine at the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA.

Objectives: Many infants in the neonatal intensive care unit (NICU) require prolonged periods of respiratory support. Microlaryngoscopy and bronchoscopy (MLB) is performed to evaluate for airway pathology and facilitate decision-making regarding further airway interventions or tracheostomy. The objectives of this study are to describe the operative findings of MLB performed on infants in the NICU and determine which pre-operative characteristics or operative findings are predictive of the need for tracheostomy. Read More

J Perinatol 2020 Jun 1. Epub 2020 Jun 1.

Department of Pediatric Surgery, John R. Oishei Children's Hospital, Buffalo, NY, USA.

Objectives: To describe variations in timing of gastrostomy tube (GT) placement for neonates undergoing tracheostomy.

Methods: Database study of neonates undergoing tracheostomy and GT placement using the Pediatric Health Information System (2012-2015). The primary outcome was timing of GT relative to tracheostomy. Read More

Pulmonology 2020 May 24. Epub 2020 May 24.

Hospital de niños de la Santísima Trinidad, Argentina.

Introduction: Acquired subglottic stenosis (SGS) occurs in 1-2% of children with a history of intubation. An alternative treatment is endoscopic dilation with rigid dilators.

Material And Methods: Seventy-four patients with SGS grade I to III were treated between 2003 and 2017. Read More

Hosp Pediatr 2020 Jun;10(6):481-488

Division of Hospital Medicine, Children's Hospital Los Angeles, Los Angeles, California; and.

Background And Objective: Technology-dependent children (TDC) are admitted to both children's hospitals (CHs) and nonchildren's hospitals (NCHs), where there may be fewer pediatric-specific specialists or resources. Our objective was to compare the characteristics of TDC admitted to CHs versus NCHs.

Methods: This was a multicenter, retrospective study using the 2012 Kids' Inpatient Database. Read More

Otolaryngol Head Neck Surg 2020 May 26:194599820923659. Epub 2020 May 26.

Department of Otorhinolaryngology-Head and Neck Surgery, Albert Einstein College of Medicine, Bronx, New York, USA.

Objectives: Our objectives were (1) to use in situ simulation to assess the clinical environment and identify latent safety threats (LSTs) related to the management of pediatric tracheostomy patients and (2) to analyze the effects of systems interventions and team factors on LSTs and simulation performance.

Methods: A multicenter, prospective study to assess LSTs related to pediatric tracheostomy care management was conducted in emergency departments (EDs) and intensive care units (ICUs). LSTs were identified through equipment checklists and in situ simulations via structured debriefs and blinded ratings of team performance. Read More

Int J Pediatr Otorhinolaryngol 2020 May 19:110090. Epub 2020 May 19.

Red Cross War Memorial Children's Hospital, Klipfontein Rd, Cape Town, 7700, SA, UK.

Laryngoscope 2020 May 21. Epub 2020 May 21.

Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, California, U.S.A.

Objectives/hypothesis: To confirm the standard of care pertaining to postoperative mobilization practices following initial tracheostomy, to establish face validity of novel early mobilization tools, and to conduct a safety and feasibility pilot study.

Study Design: Multi-institutional survey and prospective cohort study.

Methods: Experts at our tertiary-care children's hospital developed an Early Pediatric Mobility Pathway for tracheostomy patients utilizing a novel risk-assessment tool. Read More

Adv Skin Wound Care 2020 Jun;33(6):324-328

In Philadelphia, Pennsylvania, Lindsay R. Baker, RN, is Registered Nurse, Department of Nursing, Thomas Jefferson University Hospital; and Stephen R. Chorney, MD, MPH, is Pediatric Otolaryngologist, Division of Otolaryngology, Children's Hospital of Philadelphia and Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania Perelman School of Medicine. The authors have disclosed no financial relationships related to this article. Submitted November 22, 2019; accepted in revised form January 23, 2020.

Objective: To discuss prevention strategies that can mitigate the frequency of tracheostomy-related wound complications.

Data Sources: A systematic literature review of PubMed between 2010 and 2019.

Study Selection: Full-text articles written in English language and studying human participants younger than 18 years. Read More

World J Otorhinolaryngol Head Neck Surg 2020 Mar 29;6(1):49-52. Epub 2020 Mar 29.

Department of ENT, Sur Hospital, South Sharqiya Region, Sur, Sultanate of Oman.

Objective: To find out the type of bacteria colonising the tracheostomy tube and to determine the antibiotic sensitivity pattern and resistance in patients who have had tracheostomy in intensive care unit (ICU) set up and to initiate proper empirical treatment in such patients.

Methods: The study was a retrospective review of patients who underwent tracheostomy at Ministry of Health, Sur Hospital, Oman January 2005 and December 2015. The Hospital has 4 bedded pediatric intensive care unit (PICU) and 10 bedded adult ICU which is headed by consultant anaesthetists, consultant physicians, ICU trained nurses and respiratory therapists. Read More

Ear Nose Throat J 2020 May 19:145561320924868. Epub 2020 May 19.

Department of Pediatric Otolaryngology, Texas Children's Hospital, Houston, TX, USA.

Introduction: Vincristine (VCR) is a chemotherapeutic agent used widely in the treatment of hematologic and solid tumors, known to result in neurotoxicity, especially with cumulative administrations. Bilateral vocal fold palsy (VFP) is a rare but life-threatening complication of VCR. We report 2 patients with hepatoblastoma presenting with stridor following VCR treatment and propose a management plan. Read More

Clin Infect Dis 2020 May 7. Epub 2020 May 7.

Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan.

Background: Acute encephalitis/encephalopathy (AE) associated with viral and other pathogens leads to neurological sequelae and mortality. Knowing the prognostic factors is therefore important for immediate interventions. We examined early-phase unfavorable prognostic factors among children with AE using a nationwide database. Read More

Neoreviews 2020 May;21(5):e323-e334

Department of Otolaryngology, Head and Neck Surgery. Stanford University School of Medicine, Stanford, CA.

Approximately half of all pediatric tracheostomies are performed in infants younger than 1 year. Most tracheostomies in patients in the NICU are performed in cases of chronic respiratory failure requiring prolonged mechanical ventilation or upper airway obstruction. With improvements in ventilation and management of long-term intubation, indications for tracheostomy and perioperative management in this population continue to evolve. Read More

Neoreviews 2020 May;21(5):e308-e322

Eudowood Division of Pediatric Respiratory Sciences, Johns Hopkins University, Baltimore, MD.

Vocal fold paralysis (VFP) is an important cause of respiratory and feeding compromise in infants. The causes of neonatal VFP are varied and include central nervous system disorders, birth-related trauma, mediastinal masses, iatrogenic injuries, and idiopathic cases. Bilateral VFP often presents with stridor or respiratory distress and can require rapid intervention to stabilize an adequate airway. Read More

Pediatr Neonatol 2020 Apr 4. Epub 2020 Apr 4.

Respiratory Therapy Section for Children, Changhua Christian Children Hospital, Changhua, Taiwan. Electronic address:

Background: The sputum Gram stain is an inexpensive, rapid, and convenient laboratory method that predicts the bacterial pathogens in patients with pneumonia. This study aimed to evaluate the diagnostic performance of this method in predicting sputum culture results for critically ill pediatric patients.

Methods: From June 2008 to June 2018, patients with pneumonia with an endotracheal or a tracheostomy tube in place in the Pediatric Intensive Care Unit at Changhua Christian Hospital were enrolled retrospectively. Read More

Laryngoscope 2020 Apr 24. Epub 2020 Apr 24.

Department of Otolaryngology-Head and Neck Surgery,, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, U.S.A.

Objective/hypothesis: To assess the long-term decannulation outcomes of bioresorbable microplates as an external stent for pediatric tracheostomy patients with suprastomal collapse.

Study Design: Retrospective cohort study.

Methods: Hospital records of all patients who underwent a bioresorbable microplate for suprastomal collapse from 2016 to 2019 were reviewed at a single institution. Read More

J Health Care Chaplain 2020 Apr 22:1-13. Epub 2020 Apr 22.

Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA.

Children with medical complexity (CMC) receive life-sustaining treatments such as tracheostomy. The objective of this paper is to explore the roles of religion and spirituality (R&S) of caregivers of children with medical complexity (CMC) in their decision to pursue tracheostomy for their children. We conducted 41 in-depth interviews of caregivers of CMC who had received tracheostomies in the prior 5 years. Read More

Otolaryngol Head Neck Surg 2020 Apr 21:194599820917620. Epub 2020 Apr 21.

Division of Otolaryngology, Department of Surgery, University of California San Diego, San Diego, California, USA.

Objectives: To investigate the outcomes of pediatric tracheostomy as influenced by demographics and comorbidities.

Study Design: Retrospective national database review.

Setting: Fifty-two children's hospitals across the United States. Read More

Int J Pediatr Otorhinolaryngol 2020 Apr 9;134:110025. Epub 2020 Apr 9.

Department of Otolaryngology, Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, MA, USA. Electronic address:

Objective: Value-based care models are becoming instrumental in structuring clinical care delivery in our healthcare climate. Our objective was to determine the value associated with implementation of a Family-Centered Care Coordination (FCCC) program for neonates undergoing tracheostomy.

Methods: A multi-disciplinary FCCC program was implemented at the Massachusetts Eye and Ear Infirmary and MassGeneral Hospital for Children in January 2013. Read More

Crit Care Med 2020 May;48(5):e429

Department of Pediatrics, CHU Sainte-Justine, University of Montreal, Montreal, QC, Canada, and Department of Pediatrics, Children's Hospital Eastern Ontario, University of Ottawa, Ottawa, ON, Canada Department of Pediatrics, Children's Hospital of Eastern Ontario, University of Montreal, Montreal, QC, Canada.

Pediatr Neurol 2020 Feb 7. Epub 2020 Feb 7.

Department of Neurology, Perelman School of Medicine, Philadelphia, Pennsylvania; Pediatric Neurology Health Services Research Group, Department of Neurology, Perelman School of Medicine, Philadelphia, Pennsylvania; Translational Center of Excellence for Neuroepidemiology and Neurology Outcomes Research, Department of Neurology, Perelman School of Medicine, Philadelphia, Pennsylvania; Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania. Electronic address:

Background: The burden and characteristics of unplanned readmission after epilepsy-related discharge in children in the United States is not known.

Methods: We undertook a retrospective cohort study of children aged one to 17 years discharged after a nonelective hospitalization for epilepsy, sampled from the Healthcare Cost and Utilization Project's 2013 and 2014 Nationwide Readmissions Database. Descriptive statistics and logistic regression models were used to examine the characteristics of initial hospitalization and risk factors for readmission. Read More

Laryngoscope 2020 Apr 13. Epub 2020 Apr 13.

Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, OH, U.S.A.

Objectives/hypothesis: Both flexible and rigid bronchoscopy can be used to assess tracheomalacia; however, there is limited evidence comparing the two techniques. The objective of this study was to compare flexible and rigid bronchoscopy for evaluating the location and severity of tracheomalacia in children.

Study Design: Retrospective case series. Read More

Arch Pediatr 2020 Apr 9. Epub 2020 Apr 9.

Pediatric Intensive Care Unit, CHU Sainte-Justine, Montreal, Canada; University of Montreal, Montreal, Canada. Electronic address:

Objectives: Pediatric tracheostomy has evolved significantly in the past few decades and the optimal timing to perform it in children with respiratory assistance is still debated. The objective of this study was to describe the indications, timing, complications, and outcomes of infants on respiratory support who had a tracheostomy in a tertiary pediatric intensive care unit (PICU).

Methods: All children younger than 18 months of corrected age requiring respiratory support for at least 1 week and who had a tracheostomy between January 2005 and December 2015 were included. Read More

Int J Pediatr Otorhinolaryngol 2020 Mar 31;134:110028. Epub 2020 Mar 31.

Medical College of Wisconsin, Department of Otolaryngology, Milwaukee, WI, USA; Children's Hospital of Wisconsin, Department of Otolaryngology/Medical College of Wisconsin, Milwaukee, WI, USA.

Introduction: Positive tracheal cultures obtained after tracheostomy are often considered organ/space surgical site infections by the National Surgical Quality Improvement Project. However, the definition of bacterial tracheitis after tracheostomy is not well described.

Objective: To determine the relationship of positive tracheal cultures in the 30 days following pediatric tracheostomy, antibiotic treatment of these cultures, and signs/symptoms of respiratory infection. Read More

Pediatr Pulmonol 2020 Apr 8. Epub 2020 Apr 8.

Department of Pediatrics, Section of Pulmonology and Sleep Medicine, The Breathing Institute, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado.

Introduction: Mucolipidosis type II (MLII) is a lysosomal storage disease causing systemic deposition of mucopolysaccharides. We describe imaging and bronchoscopy findings not previously reported in the literature in a child with MLII.

Case: A 9-year-old with MLII s/p hematopoietic stem-cell transplant (HSCT), bronchiectasis, and aspiration presented with recurrent respiratory illnesses. Read More

Childs Nerv Syst 2020 Apr 8. Epub 2020 Apr 8.

Department of Neurosurgery, Division of Pediatric Neurosurgery, Baylor College of Medicine, Texas Children's Hospital, 6621 Fannin St, Houston, TX, 77030, USA.

Purpose: Posterior fossa tumor (PFT) resection can be associated with postoperative respiratory failure. We aimed to identify risk factors predicting tracheostomy dependence in children after PFT resection.

Methods: Retrospective chart review of all children undergoing PFT resection from April 2007 to May 2017 at our institution was performed. Read More

Ann Am Thorac Soc 2020 Apr 8. Epub 2020 Apr 8.

Children's Hospital Boston, 1862, Anesthesiology, Perioperative, and Pain Medicine, Boston, Massachusetts, United States.

Rationale: Expansion of chronic ventilation options and shared-decision making have contributed to an increasing population of technology-dependent children. One particularly vulnerable group is children with tracheostomy who depend on technology for basic respiratory functions. Chronic critical care is now provided in the homecare setting with implications for family caregivers. Read More

Int J Pediatr Otorhinolaryngol 2020 Mar 26;134:110020. Epub 2020 Mar 26.

Department of Otolaryngology - Head and Neck Surgery, Geisinger Health System, 100 North Academy Avenue, Danville, PA, 17821, USA.

Objectives: To determine the relationship between body mass index and tracheal airway size in children.

Methods: Retrospective case series. CT or MRI images of the neck of 171 pediatric patients obtained from 2000 to 2010 at a tertiary pediatric hospital were analyzed. Read More

Pediatr Pulmonol 2020 Jun 6;55(6):1503-1511. Epub 2020 Apr 6.

Department of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.

Background: The requirement for a tracheostomy in children is associated with significant morbidity, mortality, and healthcare utilization. Easy identification of children with tracheostomies would facilitate important research on this population and provide quality improvement initiatives.

Aim: The purpose of this study is to determine whether an algorithm of diagnostic and procedural codes can accurately identify children hospitalized with a tracheostomy using routinely collected health data. Read More

Arthritis Rheumatol 2020 Apr 6. Epub 2020 Apr 6.

Systemic Autoimmunity Branch, National Institutes of Health, NIAMS, Bethesda, MD, USA.

Background/purpose: Relapsing polychondritis (RP) is a systemic disease. Failure to recognize RP can lead to diagnostic delay and further complications including death. The study objective was to identify clinical patterns in a prospective cohort of patients with RP. Read More

Int J Pediatr Otorhinolaryngol 2020 Mar 24;134:110019. Epub 2020 Mar 24.

Children's Hospital of Wisconsin, Department of Otolaryngology/Medical College of Wisconsin, Milwaukee, WI, USA. Electronic address:

Transitioning children with Congenital Central Hypoventilation Syndrome (CCHS) from nocturnal invasive ventilation via tracheostomy to noninvasive positive pressure ventilation (NIPPV) is challenging due to the leak caused by the tracheocutaneous fistula (TCF), resulting in insufficient ventilation. Decannulation and primary closure of the TCF with immediate transition to nocturnal NIPPV was performed in two children with CCHS at a tertiary care children's hospital. Neither child developed significant adverse effects such as pneumomediastinum or pneumothorax. Read More

Vestn Otorinolaringol 2020 ;85(1):30-33

Saint Petersburg State Pediatric Medical University of the Ministry of Health of Russia, Department of Otolaryngology, Saint Petersburg, Russia, 194100.

Aim: To optimize the current algorithms of diagnosis and treatment of children with congenital laryngeal paralysis.

Method: A retrospective study of case histories of patients with congenital laryngeal paralysis who were examined and treated at St. Petersburg State Pediatric Medical University. Read More

Spine Deform 2020 Mar 30. Epub 2020 Mar 30.

Division of Orthopaedics, The Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA, 19104, USA.

Objectives: The aim of this study is to determine risk factors for infection among EOS patients treated by rib-based distraction instrumentation, and to further assess the incidence of infection among C-EOS categories and sub-types. Despite the heterogonous nature of early onset scoliosis, the classification of early onset scoliosis (C-EOS) has proven to have excellent reliability across its major categories. C-EOS's reliability has been verified; however, little data exist on the utility of this categorization in clinical decision-making and risk assessment. Read More

Bioelectron Med 2019 17;5:15. Epub 2019 Sep 17.

Orthopaedic Research Laboratory, The Feinstein Institutes for Medical Research, 350 Community Drive, Manhasset, NY 11030 USA.

Congenital tracheomalacia and tracheal stenosis are commonly seen in premature infants. In adulthood, are typically related with chronic obstructive pulmonary disease, and can occur secondarily from tracheostomy, prolong intubation, trauma, infection and tumors. Both conditions are life-threatening when not managed properly. Read More

Int J Artif Organs 2020 Mar 31:391398820913571. Epub 2020 Mar 31.

Department of Surgery, Levine Children's Hospital, Charlotte, NC, USA.

Objective: Pediatric extracorporeal membrane oxygenation typically necessitates protracted ventilator support, yet not much is known about the use of tracheostomy in the pediatric subpopulation. The study was designed with an objective to quantify the prevalence of tracheostomy in children with respiratory/cardiac failure requiring extracorporeal membrane oxygenation and to compare outcomes for patients undergoing early, late, and no tracheostomy.

Methods: Data of patients <18 years of age who underwent extracorporeal membrane oxygenation for respiratory/cardiac failure between 2009 and 2015 were obtained from the Virtual Pediatric Systems (VPS, LLC) Database. Read More

Pediatr Crit Care Med 2020 Mar 12. Epub 2020 Mar 12.

All authors: Division of Pediatric Critical Care, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI.

Objectives: The use and outcomes of nasotracheal intubation in pediatric patients requiring mechanical ventilation have not been quantified. Our goal is to identify prevalence of use, associated factors, and outcomes of nasotracheal versus orotracheal intubation in patients requiring mechanical ventilation.

Design: Retrospective cohort study using deidentified data from the Virtual Pediatric Systems database. Read More

Otolaryngol Head Neck Surg 2020 Mar 24:194599820911728. Epub 2020 Mar 24.

Pediatric Otolaryngology-Head and Neck Surgery, Seattle Children's Hospital, Seattle, Washington, USA.

Objective: To describe the Trach Safe Initiative and assess its impact on unanticipated tracheostomy-related mortality in outpatient tracheostomy-dependent children (TDC).

Methods: An interdisciplinary team including parents and providers designed the initiative with quality improvement methods. Three practice changes were prioritized: (1) surveillance airway endoscopy prior to hospital discharge from tracheostomy placement, (2) education for community-based nurses on TDC-focused emergency airway management, and (3) routine assessment of airway events for TDC in clinic. Read More

Int J Pediatr Otorhinolaryngol 2020 Jun 8;133:109986. Epub 2020 Mar 8.

Department of Pediatric Otolaryngology, Head and Neck Surgery, Auckland Starship Children's Hospital, Park Road, Grafton, Auckland, New Zealand; Department of Surgery, University of Auckland, Auckland Starship Children's Hospital, Park Road, Grafton, Auckland, New Zealand.

Objectives: Pediatric tracheostomy is performed in a variety of complex, comorbid patients. Tracheostomy involves a significant burden of care for families and a risk of life-threatening complications. There is little research regarding the ideal location and protocol for safe tracheostomy decannulation. Read More

JAMA Otolaryngol Head Neck Surg 2020 Mar 19. Epub 2020 Mar 19.

Research Group on Ventilatory Handicap (EA 3830 GRHV), The Rouen Institute for Research and Innovation in Biomedicine, Rouen, Normandy, France.

Importance: Bilateral vocal fold paralysis (BVFP) in pediatric patients is a challenging entity with multiple causes. Traditional approaches to managing BVFP include tracheostomy, arytenoidectomy, suture lateralization, cordotomy, and posterior cricoid enlargement. These interventions are used to create a stable airway but risk compromising voice quality. Read More

J Craniofac Surg 2020 Mar 13. Epub 2020 Mar 13.

Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY.

Background: The authors present an institutional experience treating congenital and acquired temporomandibular joint (TMJ) ankylosis, detailing outcomes and potential risk factors of recurrence.

Methods: Retrospective chart review identified patients with TMJ ankylosis (1976-2019). Clinical records, operative reports, and imaging studies were reviewed for demographics, surgical operations, and ankylosis including maximal interincisal opening (MIO) and re-ankylosis. Read More

Cleft Palate Craniofac J 2020 Jun 16;57(6):736-745. Epub 2020 Mar 16.

Department of Biomedical Informatics, University of Utah, Salt Lake City, UT, USA.

Objective: To identify concepts and constructs important to parents of children with Pierre Robin Sequence (PRS).

Design: Qualitative study.

Setting: All children received some care at a tertiary hospital with additional care at outside facilities. Read More

Int J Pediatr Otorhinolaryngol 2020 Jun 4;133:109982. Epub 2020 Mar 4.

Department of Otolaryngology-Head & Neck Surgery, Stanford University School of Medicine, Stanford, CA, USA; Pediatric Aerodigestive and Airway Reconstruction Center, Lucile Packard Children's Hospital, Stanford, Stanford, CA, USA. Electronic address:

Objective: Despite recent guidelines and the frequency of pediatric tracheostomy, surgical techniques and perioperative management are variable. We aim to describe the post-operative practice patterns following tracheostomy in children.

Methods: An electronic cross-sectional survey was distributed to American Society of Pediatric Otolaryngologists (ASPO) members in academic and private practice settings. Read More

Pediatr Crit Care Med 2020 Mar 10. Epub 2020 Mar 10.

Department of Pediatrics, Division of Cardiology, University of Arkansas for Medical Sciences and Arkansas Children's Hospital Research Institute, Little Rock, AR.

Objectives: Caring for a child with gastrostomy and/or tracheostomy can cause measurable parental stress. It is generally known that children with 22q11.2 deletion syndrome are at greater risk of requiring gastrostomy or tracheostomy after heart surgery, although the magnitude of that risk after complete repair of tetralogy of Fallot has not been described. Read More

Pediatr Crit Care Med 2020 Apr;21(4):385-388

Division of Medical Toxicology, Department of Emergency Medicine, University of Texas Southwestern Medical Center, Dallas, TX.

Objectives: To report a severe case of e-cigarette or vaping product use-associated lung injury with complex course requiring venovenous extracorporeal membrane oxygenation.

Design: Case report.

Setting: PICU in an academic medical center. Read More

J Neuropathol Exp Neurol 2020 Apr;79(4):365-369

Department of Neurology, Loma Linda University Medical Center, Loma Linda, California.

A 29-year-old man presented with rapidly progressive severe neck weakness, asymmetrical bilateral upper extremity weakness, bulbar dysfunction, profound muscle wasting, and weight loss. Within 1 year, his speech became unintelligible, he became gastrostomy- and tracheostomy/ventilator-dependent, and wheelchair bound. Electrophysiology suggested motor neuron disease. Read More

Laryngoscope Investig Otolaryngol 2020 Feb 3;5(1):168-174. Epub 2020 Jan 3.

Department of Anesthesiology and Pain Medicine Nationwide Children's Hospital Columbus Ohio.

Objectives: Postoperative respiratory adverse events (PRAEs) are known complications following adenotonsillectomy (AT). Clinical data at a single institution were reviewed to investigate the factors that may contribute to PRAEs in the postanesthesia care unit (PACU). The relationship between PRAEs in the PACU and escalation of care, defined as either an unplanned admission for outpatient surgery or unplanned pediatric intensive care unit (PICU) admission, was investigated. Read More

J Burn Care Res 2020 Feb 29. Epub 2020 Feb 29.

Massachusetts Eye and Ear Infirmary, Department of Otolaryngology Head and Neck Surgery, Boston, MA, USA.

The management of laryngotracheal stenosis (LTS) in the pediatric burn patient is complex and requires a multi-disciplinary approach. The mainstay of treatment for LTS is laryngotracheal reconstruction (LTR), however, limited reports of burn-specific laryngotracheal reconstruction techniques exist. Here, we provide insight into the initial airway evaluation, surgical decision-making, anesthetic challenges, and incision modifications based on our experience in treating patients with this pathology. Read More

J Burn Care Res 2020 Feb 29. Epub 2020 Feb 29.

The Division of Plastic Surgery, Department of Surgery, Albany Medical Center, Albany, NY, USA.

Tracheocutaneous fistula (TCF) is a common complication that occurs after decannulation of a long-term tracheostomy. Numerous studies have demonstrated the incidence of TCF formation to positively correlate with an increasing duration of cannulation, specifically in children. Treatment of a persistent TCF in a child has been well described in the literature, with good response to local measures like curettage and silver nitrate. Read More

Rehabil Nurs 2020 Feb 26. Epub 2020 Feb 26.

Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, Atlanta, GA, USA.

Routine tracheostomy care in children maintains airway patency, minimizes infection, and ensures skin integrity around the tracheostomy stoma to prevent complications. Using evidence-based recommendations for care of the mature tracheostomy limits variation in practice and leads to better patient outcomes in all care settings. Incorporating evidence-based care into practice is especially important because children with tracheostomies are at high risk for morbidity and mortality. Read More

Crit Care Med 2020 May;48(5):725-731

VA Center for Clinical Management Research, HSR&D Center of Innovation, Ann Arbor, MI.

Objectives: Severe sepsis is a significant cause of healthcare utilization and morbidity among pediatric patients. However, little is known about how commonly survivors acquire new medical devices during pediatric severe sepsis hospitalization. We sought to determine the rate of new device acquisition (specifically, tracheostomy placement, gastrostomy tube placement, vascular access devices, ostomy procedures, and amputation) among children surviving hospitalizations with severe sepsis. Read More