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Curr Opin Pediatr 2019 Mar 18. Epub 2019 Mar 18.

Section of Pulmonary Medicine and Pediatric Heart Lung Center, Department of Pediatrics, University of Colorado, School of Medicine, Aurora, Colorado, USA.

Purpose Of Review: Modern medical advances have resulted in an increased survival after extremely preterm birth. However, some infants will develop severe bronchopulmonary dysplasia (BPD) and fail to wean from invasive or noninvasive positive pressure support. It remains unclear which infants will benefit from tracheostomy placement for chronic ventilation. Read More

J Trauma Acute Care Surg 2019 Mar 13. Epub 2019 Mar 13.

Division of Pediatric General Surgery, UCSF Benioff Children's Hospital Oakland, Oakland, CA.

Background: Early tracheostomy has been associated with shorter hospital stay and fewer complications in adult trauma patients. Guidelines for tracheostomy have not been established for children with severe TBI. The purpose of this study was to 1) define nationwide trends in time to extubation and time to tracheostomy; and 2) determine if early tracheostomy is associated with decreased length of stay and fewer complications in children with severe TBI. Read More

Int J Pediatr Otorhinolaryngol 2019 Feb 27;121:64-67. Epub 2019 Feb 27.

Department of Otolaryngology - Head and Neck Surgery, College of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea. Electronic address:

Objective: The incidence of SGS has been reported to be less than 8% after endotracheal intubation. Therefore there is an increasing trend in the number of patients with acute acquired SGS due to mechanical ventilation in the intensive care unit. However, there have been no reports describing the treatment of SGS in children in South Korea. Read More

J Pediatr 2019 Mar 11. Epub 2019 Mar 11.

Section of Cardiology, Department of Pediatrics, University of Colorado Denver School of Medicine, Denver, CO.

Objectives: To assess whether better baseline pulmonary hemodynamics or positive acute vasoreactivity testing (AVT) during cardiac catheterization are associated with improved outcomes in infants with bronchopulmonary dysplasia (BPD) and pulmonary hypertension (PH).

Study Design: This retrospective, single-center study included 26 premature neonates with BPD who underwent catheterization to evaluate PH. AVT was assessed with exposure to 100% fractional inspired oxygen with or without inhaled nitric oxide. Read More

Hosp Pediatr 2019 Mar 13. Epub 2019 Mar 13.

Division of Pediatric Critical Care Medicine, Rainbow Babies and Children's Hospital, University Hospitals Cleveland Medical Center, Cleveland, Ohio.

Objective: Describe clinical outcomes and risk factors for ICU readmissions in a cohort of children who underwent tracheostomy placement after cardiac arrest.

Methods: A retrospective, multicenter cohort analysis of children <18 years old admitted to a Virtual Pediatric Systems, LLC-participating PICU from January 2009 to December 2016 and underwent tracheostomy after cardiac arrest.

Results: Among 394 index admissions, the median age was 16. Read More

Clin Plast Surg 2019 Apr 8;46(2):249-259. Epub 2019 Feb 8.

Pediatric Plastic Surgery, Craniofacial Program, Rhode Island Hospital, The Warren Alpert Medical School of Brown University, 2 Dudley Street, Suite 180, Providence, RI 02905, USA. Electronic address:

Pierre Robin sequence consists of clinical triad of micrognathia, glossoptosis, and airway compromise with variable inclusion of cleft palate. Evaluation of airway obstruction includes physical examination, polysomnography for obstruction events, and a combination of nasoendoscopy and bronchoscopy to search for synchronous obstructive lesions. A multidisciplinary approach is required given the high rate of syndromic disease. Read More

J Med Case Rep 2019 Mar 10;13(1):73. Epub 2019 Mar 10.

Neonatal Intensive Care Unit, Ruth Rappaport Children's Hospital, Rambam Health Campus, Haifa, Israel.

Background: A giant congenital cervical teratoma is often highly vascularized; thus, in addition to a life-threatening airway occlusion at birth it comprises a high risk for significant and lethal blood loss during resection. In the case presented, an endovascular embolization of the carotid artery that supplied a giant congenital cervical teratoma was done as part of a three-stage treatment soon after birth and contributed to an overall good outcome. Embolization in cases of cervical teratomas was not described previously. Read More

J Pediatr Surg 2019 Feb 23. Epub 2019 Feb 23.

Department of Pediatric Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea.

Background/purpose: Haddad syndrome (HS) is a very rare disease considered a form of neurocristopathy. It is characterized by a combination of congenital central hypoventilation syndrome (CCHS) and Hirschsprung's disease (HD). We report the clinical features and disease progression of HS to provide better care for HS patients by achieving an earlier diagnosis and optimal treatment. Read More

Laryngoscope 2019 Mar 5. Epub 2019 Mar 5.

Department of Otolaryngology, Children's National Health System, Washington, DC, U.S.A.

Objectives/hypothesis: Laryngotracheal reconstruction (LTR) is a collection of procedures used to treat pediatric laryngotracheal stenosis. Arytenoid prolapse is a potential postoperative complication that may lead to upper airway obstruction. This study investigates the incidence, risk factors, and need for surgical intervention for post-LTR arytenoid prolapse. Read More

Pediatr Clin North Am 2019 04 1;66(2):489-508. Epub 2019 Feb 1.

Special Infant Care Follow-up Program, Department of Pediatrics/Neonatology, Duke University Medical Center, Box 2739, Durham, NC 27710, USA.

Premature and critically ill term infants are often discharged from the neonatal intensive care unit (NICU) with ongoing medical problems, including respiratory problems; growth, nutrition and feeding problems; and neurologic injury. At discharge, they may also be dependent on technology such as supplemental oxygen, tracheostomy, mechanical ventilation, feeding tube, and monitors. Primary care physicians must have special knowledge and understanding of the medical complications of NICU graduates to coordinate post-discharge care. Read More

Int J Pediatr Otorhinolaryngol 2019 Jan 25;120:157-161. Epub 2019 Jan 25.

Emory University School of Medicine Departments of Pediatrics and Otolaryngology, USA; Children's Healthcare of Atlanta at Egleston, USA.

Introduction: Children with tracheostomies are medically complex and may be discharged with limited and variably trained home nursing support. When faced with emergencies at home, caregivers must often take the lead role in management, and many lack experience with troubleshooting these emergencies prior to initial discharge.

Methods: A high-fidelity simulation-based tracheostomy education program was designed using a programmable mannequin (Gaumard HAL S3004 one-year-old pediatric simulator). Read More

Medicine (Baltimore) 2019 Mar;98(9):e14691

Department of Medicine, MacKay Medical College.

To determine the natural history of patient with bilateral vocal fold immobility (BVFI), and to identify the factors or predictors associated with the tracheostomy and duration of cannulation for those who require tracheostomy.A retrospective review was carried out at a single tertiary referral center over a 23-year period of infants less than 1 year old who presented with BVFI. All information related to sex, etiology, gestational age at birth, vocal fold (VF) position at diagnosis, presence of concomitant airway disease, age at attainment of VF movement, age at decannulation, and current tracheostomy status were recorded to perform descriptive and comparative analyses. Read More

Pediatrics 2019 Mar;143(3)

Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California

Background: Early administration of anti-influenza medications is recommended for all children hospitalized with influenza. We investigated whether early use of anti-influenza medications is associated with improved outcomes in children with tracheostomy hospitalized with influenza.

Methods: We performed a multicenter retrospective cohort study through the Pediatric Health Information System database for patients aged 30 days to 19 years who were discharged between October 1, 2007, and September 30, 2015 with diagnostic codes for both influenza and tracheostomy. Read More

Laryngoscope 2019 Feb 22. Epub 2019 Feb 22.

Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan.

Objectives/hypothesis: To report the clinical safety and efficacy of three-dimensional (3D)-printed, patient-specific, bioresorbable airway splints in a cohort of critically ill children with severe tracheobronchomalacia.

Study Design: Case series.

Methods: From 2012 to 2018, 15 subjects received 29 splints on their trachea, right and/or left mainstem bronchi. Read More

JAMA Otolaryngol Head Neck Surg 2019 Feb 21. Epub 2019 Feb 21.

Pediatric Intensive Care, Raymond Poincaré University Hospital, APHP, Garches, France.

J Otolaryngol Head Neck Surg 2019 Feb 19;48(1):10. Epub 2019 Feb 19.

Centre for Medical Education, McGill University, Montreal, Canada.

Background: A longitudinal curriculum was developed in conjunction with anesthesiologists, otolaryngologists, emergency physicians and experts in medical simulation and education.

Methods: Residents participated in four different simulation-based training modules using animal models, cadavers, task trainers, and crisis scenarios using high fidelity manikins. Scenarios were based on various clinical settings (i. Read More

Surg Today 2019 Feb 18. Epub 2019 Feb 18.

Department of Pediatric Surgery, Osaka Women's and Children's Hospital, 840, Murodocho, Izumi, Osaka, Japan.

Purpose: Airway obstruction caused by lymphatic malformation (LM) in the head and neck may require a tracheostomy. We present the results of our analysis of a nationwide survey on the indications for tracheostomy in children with head and neck LM.

Methods: We analyzed data in relation to tracheostomy based on a questionnaire about 518 children with head and neck LM without mediastinal involvement. Read More

Int J Pediatr Otorhinolaryngol 2019 Feb 8;120:78-81. Epub 2019 Feb 8.

Department of Pediatric Otorhinolaryngology, Our Lady's Children's Hospital Crumlin, Dublin, Ireland.

Objectives: The first tracheostomy tube change is typically performed on days 5-7 post-operatively, however recent international consensus guidelines suggested that, with maturation sutures, days 3-5 is appropriate. We evaluate whether a first tube change on day 2 post-operatively is safe and effective.

Methods: We carried out a retrospective review of all patients undergoing tracheostomy between 2009 and 2018. Read More

Hand (N Y) 2019 Feb 15:1558944719828003. Epub 2019 Feb 15.

1 Yale University School of Medicine, New Haven, CT, USA.

Purpose: Being one of the most common congenital hand malformations, syndactyly is repaired by orthopedic, plastic, and fellowship-trained general surgeons. Limited multi-institutional outcomes analyses regarding incidence, timing, and type of repair exist.

Methods: All syndactyly cases performed over a 5-year period from 2012-2016 were isolated from the National Surgical Quality Improvement Program Pediatric database. Read More

Can J Anaesth 2019 Feb 14. Epub 2019 Feb 14.

The Children's Hospital of Philadelphia, Department of Anesthesiology and Critical Care Medicine, Perelman School of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.

Purpose: Pediatric patients undergoing complex cranial vault reconstruction (CCVR) are at risk of significant perioperative blood loss requiring blood product transfusion. Minimizing allogeneic blood product transfusion is an important goal because of the associated risks and cost. The impact of patient and surgical variables on transfusion is unknown in this population. Read More

BMJ Open 2019 Feb 12;9(2):e022600. Epub 2019 Feb 12.

Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.

Introduction: Predicting successful liberation from mechanical ventilation (MV) among critically ill patients receiving MV can be challenging. The current parameters used to predict successful extubation have shown variable predictive value. Brain natriuretic peptide (BNP) has been proposed as a novel biomarker to help guide decision-making in readiness for liberation of MV following a spontaneous breathing trial (SBT). Read More

Int J Pediatr Otorhinolaryngol 2019 Feb 5;120:40-43. Epub 2019 Feb 5.

University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States.

Objectives: To study the incidence, sequelae, follow up, and recovery rate of vocal fold motion impairment (VFMI) after complex aortic arch reconstruction in neonates.

Study Design: Retrospective case control study.

Methods: We retrospectively evaluated 105 neonates who underwent complex aortic arch reconstruction from 2014 to 2016. Read More

Indian Pediatr 2018 12;55(12):1091-1092

Pediatric Critical Care and Pulmonology, Sri Balaji Action Medical Institute, New Delhi, India.

The feasibility and safety of pediatric tracheostomy care at home by parents is challenging. Many physicians are not confident of sending tracheostomized children home. We describe our experience with 12 children who underwent tracheostomy and were sent home. Read More

Am J Med Genet A 2019 Apr 4;179(4):655-658. Epub 2019 Feb 4.

Department of Pediatrics, Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.

The congenital myasthenic syndromes (CMS) are a heterogeneous group of disorders caused by perturbations in signal transduction at the neuromuscular junction. Defects in muscle, skeletal, receptor tyrosine kinase (MuSK) cause two distinct phenotypes: fetal akinesia with multiple congenital anomalies (Fetal akinesia deformation sequence [MIM:208150]) and early onset congenital myasthenia (myasthenic syndrome, congenital, 9, associated with acetylcholine receptor deficiency [MIM:616325]). Myasthenia due to MuSK deficiency has variable clinical features, ranging from a milder presentation of isolated late-onset proximal muscle weakness; to a severe presentation of prenatal-onset diffuse weakness, ophthalmoplegia, respiratory failure, and vocal cord paralysis (VCP). Read More

Prenat Diagn 2019 Feb 1. Epub 2019 Feb 1.

Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX.

Background: The Ex-Utero Intrapartum Treatment (EXIT) is utilized to transition fetuses with prenatally diagnosed airway obstruction to postnatal life. We describe the unique clinical course, diagnosis, treatment and outcomes of patients with cervical lymphatic malformation (CLM) managed with EXIT.

Methods: Review of fetuses with diagnosed CLM delivered by EXIT (2001-2018) in a tertiary referral fetal center. Read More

Ann Thorac Surg 2019 Feb 26;107(2):553-559. Epub 2018 Oct 26.

Department of Pediatrics, Indiana University School of Medicine, Riley Hospital for Children, Indianapolis, Indiana.

Background: Literature describing morbidity and mortality after truncus arteriosus repair is predominated by single-center reports. We created and analyzed a multicenter dataset to identify risk factors for late mortality and right ventricle-to-pulmonary artery (RV-PA) conduit reintervention for this patient population.

Methods: We retrospectively collected data on children who underwent repair of truncus arteriosus without concomitant arch obstruction at 15 centers between 2009 and 2016. Read More

Pediatr Emerg Care 2019 Jan 21. Epub 2019 Jan 21.

From the Royal Manchester Children's Hospital, Manchester, England.

Background: Laryngeal trauma in pediatrics is extremely rare; however, because of the smaller pediatric larynx, it can have catastrophic consequences. Following laryngeal trauma, surgical emphysema is a relatively common presentation. In pediatrics, it can be a life-threatening condition. Read More

Paediatr Respir Rev 2018 May 17. Epub 2018 May 17.

Cambia Health Foundation Endowed Chair in Pediatric Palliative Care, Oregon Health and Science University, 707 SW Gaines Street, Mailcode CDRCP, Portland, OR 97239, United States. Electronic address:

Progressive neuromuscular disease requires increasing degrees of respiratory support to sustain life. Each step from intermittent to continuous-and noninvasive to invasive-ventilation requires thoughtful consideration based on the goals of the patient and family, and the inherent benefits and burdens of the treatment. Tracheostomy, in particular, should not be viewed as an inevitable next step when less permanent or invasive methods prove insufficient. Read More

Acta Medica (Hradec Kralove) 2018 ;61(4):150-152

Department of Pathology, All India Institute of Medical Sciences, New Delhi, India.

Anaplastic thyroid carcinoma (ATC), one of the most aggressive malignancies, is extremely rare in childhood. We present a case of 5-yearold child who presented with rapidly progressing thyroid swelling and stridor, for which she underwent emergency tracheostomy and biopsy. Histopathological features were suggestive of ATC and the patient died within two months after diagnosis. Read More

Int J Pediatr Otorhinolaryngol 2019 Mar 8;118:188-191. Epub 2019 Jan 8.

Mansoura University, Egypt.

Objective: Suprastomal collapse is a complication of pediatric tracheotomy with a potential impact on decannulation success. The aim of this study was to review the experience in the management of pediatric suprastomal collapse in a tertiary-care center, detailing the surgical technique employed.

Methods: This study included 12 tracheotomised children with the diagnosis of suprastomal collapse in the last 5 years. Read More

Laryngoscope 2019 Jan 10. Epub 2019 Jan 10.

Department of Otolaryngology-Head & Neck Surgery, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.

Objective: Tracheo-innominate fistula (TIF) is a rare but fatal complication of tracheotomy. To date, there is a paucity of literature regarding pediatric TIFs. The objectives of this study were to conduct a systematic review of literature on pediatric TIF following tracheotomy and describe three demonstrative cases from our institutional experience. Read More

Telemed J E Health 2019 Jan 10. Epub 2019 Jan 10.

2 Advocate Children's Hospital, Oak Lawn, Illinois.

Background: Children with medical complexity (CMC) are high utilizers of health care services. Telehealth encounters may provide a means to improve care outcomes for this population.

Objective: To evaluate the feasibility, usability, and impact of an in-home telehealth device in the care of CMC. Read More

Indian J Pediatr 2019 Jan 9;86(Suppl 1):20-24. Epub 2019 Jan 9.

Department of Otorhinolaryngology and Head and Neck Surgery (ENT), Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India.

Foreign body aspiration in children is a problem that can lead to several complications, including death. In this retrospective publication review from 1970 to 2015, there were altogether 42 Malaysian children below the age of 15 y reported with foreign body (FB) ingestion. There were 31 boys and 11 girls between 2 and 177 mo of age. Read More

Front Pediatr 2018 18;6:401. Epub 2018 Dec 18.

Neonatal Surgery Unit, Department of Medical and Surgical Neonatology, Bambino Gesù Children's Hospital, Rome, Italy.

Presence of laryngotracheal abnormalities is associated with increased morbidity and higher mortality rate in esophageal atresia patients. Determine the prevalence of laryngotracheal abnormalities (LTA) in a prospectively collected cohort of patients treated for esophageal atresia and/or tracheoesophageal fistula (EA/TEF). Analysis of the impact of those airway anomalies in early post-operative outcomes was performed. Read More

J Pediatr 2019 Jan 4. Epub 2019 Jan 4.

Children's Hospital Association, Lenexa, KS.

Objective: To compare health care use and spending in children using vs not using respiratory medical equipment and supplies (RMES).

Study Design: Cohort study of 20 352 children age 1-18 years continuously enrolled in Medicaid in 2013 from 12 states in the Truven Medicaid MarketScan Database; 7060 children using RMES were propensity score matched with 13 292 without RMES. Home RMES use was identified with Healthcare Common Procedure Coding System and International Classification of Diseases codes. Read More

J Pediatr Nurs 2018 Dec 19;45:7-12. Epub 2018 Dec 19.

Department of Nursing, Xin Hua Hospital Affiliated to Shang Hai Jiao Tong University School of Medicine, Shanghai, China.

Purpose: The number of pediatric patients who require a long-term tracheal tube at home is gradually increasing. Studies have demonstrated that the parents of these children report high levels of stress, anxiety and other negative emotions as early as shortly after discharge from the hospital. The purpose of this study is to describe the home care experiences of parents of children with tracheostomies during the transition from hospital to home in China to more effectively address their needs. Read More

Laryngoscope 2019 Apr 28;129(4):818-822. Epub 2018 Dec 28.

Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati, Cincinnati, Ohio, U.S.A.

Objectives: 1) Evaluate success rates for adults undergoing cervical slide tracheoplasty. 2) Examine complication rates of slide tracheoplasty in adults.

Methods: A retrospective cohort of adults > 21 years of age undergoing cervical slide tracheoplasty for tracheal stenosis between October 2011 and August 2017 was reviewed. Read More

Spine Deform 2019 01;7(1):107-111

Pediatric Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA.

Objective: The objective of this study is to identify preoperative laboratory values and patient factors that are associated with postoperative respiratory complications in pediatric neuromuscular scoliosis (NMS) populations undergoing posterior spinal fusion (PSF) with instrumentation.

Summary Of Background Data: PSF in NMS patients are high-risk surgeries. Respiratory complications are the most common postoperative event, with rates up to 28. Read More

Laryngoscope 2018 Dec 25. Epub 2018 Dec 25.

Division of Pediatric Otolaryngology-Head and Neck Surgery, Cincinnati, OH, U.S.A.

Objective: Epiglottic petiole prolapse is an overlooked entity that could lead to supraglottic airway obstruction for patients with complex airway history. Classical symptoms include exercise intolerance, obstructive sleep apnea, and difficulty with decannulation. The goal of this project was to evaluate the factors associated with epiglottic petiole repositioning success. Read More

Pediatr Qual Saf 2018 Sep-Oct;3(5):e106. Epub 2018 Sep 28.

Division of Neonatology, Nationwide Children's Hospital/The Ohio State University Medical Center, Columbus, OH.

Introduction: As survival has improved in the Neonatal Intensive Care Unit (NICU), there has been a 10-fold increase in the proportion of infants requiring a tracheostomy. At our institution, we observed a wide variation in the duration of opioid use posttracheostomy from 6 to 148 days. We aimed to decrease the duration of opioid exposure in postoperative tracheostomy patients in the NICU from a baseline average of 24 days to 7 days by December 31, 2017. Read More

Braz J Otorhinolaryngol 2018 Dec 11. Epub 2018 Dec 11.

Universidade Estadual de Campinas (UNICAMP), Department of Pediatrics, Pediatric Intensive Care Unit, Hospital das Clinicas, Campinas, SP, Brazil.

Introduction: Since development of pediatric intensive care units, children have increasingly and appropriately been treated for complex surgical conditions such as laryngotracheal stenosis. Building coordinated airway teams to achieve acceptable results is still a challenge.

Objective: To describe patient demographics and surgical outcomes during the first 8years of a pediatric airway reconstruction team. Read More

Int J Pediatr Otorhinolaryngol 2019 Mar 16;118:59-61. Epub 2018 Dec 16.

Boston Children's Hospital, Department of Otolaryngology & Communication Enhancement, 300 Longwood Avenue, LO-367, Boston, MA, 02115, USA.

Objective: To report on the prevalence of voice disturbances in pediatric airway patients.

Methods: Consecutive patients seen in a specialized Center for Airway Disorders at a tertiary children's hospital from February 2017 to September 2017 were included. Patients' families were invited to complete a pediatric voice health handicap index (pVHI) questionnaire. Read More

Int J Pediatr Otorhinolaryngol 2019 Feb 19;117:127-130. Epub 2018 Nov 19.

Florida Atlantic University, Charles E. Schmidt College of Medicine, USA; Joe DiMaggio Children's Hospital, Hollywood, FL, USA. Electronic address:

Introduction: Although injection laryngoplasty (IL) is a well-accepted treatment strategy in older children and adults with unilateral vocal fold immobility (UVFI), its efficacy and safety have not been well studied in neonates and young children.

Objectives: The main objective of this study was to evaluate the clinical and radiographic effects of IL on aspiration & dysphagia in neonates and young children with UVFI.

Methods: This was a retrospective chart review of infants and children who underwent IL at a tertiary children's hospital. Read More

Int J Pediatr Otorhinolaryngol 2019 Mar 7;118:6-10. Epub 2018 Dec 7.

Department of ENT, Christian Medical College, Vellore, India.

Study Objectives: To review the key parameters related to the proposed modified pediatric tracheostomy technique with to determine the efficacy, safety and outcomes in a tertiary hospital in south India. Patients and Methods A retrospective chart review of all children aged below 16 years who underwent tracheostomy at a tertiary hospital in south India during the period of August 2014 to August 2016. Data on age, gender, indication for tracheostomy, primary disease condition, duration of intubation, complications and decannulation rate were recorded. Read More

Laryngoscope 2018 Dec 19. Epub 2018 Dec 19.

Department of Otolaryngology, UT Southwestern Medical Center, Dallas, Texas, U.S.A.

Objectives: Tracheal stenosis is a recognized complication of tracheostomy. Yet, the incidence and demographics of tracheal stenosis due to tracheostomies have infrequently been studied.

Methods: We performed a cross-sectional analysis of U. Read More

Laryngoscope 2019 Feb 22;129(2):317-323. Epub 2018 Nov 22.

Department of Otolaryngology-Head and Neck Surgery, Cincinnati, OH, U.S.A.

Objective: Biofilm formation on medical devices such as tracheostomy tubes (TTs) is a serious problem. The clinical impact of biofilms on the airway is still unclear. Biofilms may play a role in granulation tissue development, recurrent airway infections, and failure of laryngotracheal reconstructions. Read More

Int J Pediatr Otorhinolaryngol 2019 Jan 16;116:192-195. Epub 2018 Oct 16.

Albert Einstein College of Medicine, United States; Montefiore Medical Center and Children's Hospital at Montefiore, Department of Otorhinolaryngology-Head & Neck Surgery, United States. Electronic address:

Objectives: To compare the rates of skin-related complications and accidental decannulation in pediatric patients who received Velcro ties versus twill ties during the early postoperative period following tracheotomy. The rates of skin-related complications and accidental decannulation in patients with Velcro ties was hypothesized to differ from those in patients with twill ties.

Methods: Medical records of 109 patients ≤18 years old who underwent elective tracheotomy were reviewed: 70 received twill ties and 39 received Velcro ties. Read More

Pediatr Pulmonol 2019 Mar 11;54(3):333-341. Epub 2018 Dec 11.

Department of Pediatric Rehabilitation Medicine, Kennedy Krieger Institute, Baltimore, Maryland.

Objective: The objective of this retrospective review was to determine the utility of polysomnography (PSG) in influencing the decision to decannulate pediatric patients with brain and spinal cord injuries in an inpatient rehabilitation hospital setting.

Methods: Between 2010 and 2016, data were collected on pediatric patients with brain and/or spinal cord injuries who had PSG performed with the goal of decannulation. Patients underwent a decannulation protocol involving toleration of continuous tracheostomy capping and bedside tracheoscopy by otolaryngology. Read More

Pediatr Pulmonol 2019 Jan 7;54(1):53-60. Epub 2018 Dec 7.

Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

Objectives: Tracheostomy is indicated for very-low-birth-weight infants (VLBWIs) with prolonged respiratory problems during the perinatal period. The objective of this study is to clarify the epidemiology and risk factors in VLBWIs with tracheostomy after birth in Japan.

Methods: A total of 40 806 VLBWIs were registered in the Neonatal Research Network of Japan database from 2003 to 2012. Read More

AACN Adv Crit Care 2018 ;29(4):382-392

Julie Van Orne is Clinical Nurse Leader, Cook Children's Medical Center, 801 Seventh Ave, Fort Worth, TX 76104 Kaylan Branson is Clinical Nurse Leader, Cook Children's Medical Center, Fort Worth, Texas. Mary Cazzell is Director of Nursing Research and Evidence Based Practice, Cook Children's Medical Center, Fort Worth, Texas.

Background: The safe transition of children with complex medical conditions who are dependent on technology from hospital to home requires that caregivers receive specialized training from qualified health care professionals. Inadequate caregiver training can lead to discharge delays and hospital readmissions, often resulting in caregiver distress.

Objective: To determine the effectiveness of a structured boot camp-style predischarge training program for caregivers of pediatric patients with complex medical conditions. Read More