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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. 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 2018 Dec 28. 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 Jan;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 2018 Dec 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 2018 Dec 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 2018 Nov 22. 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 2018 Dec 11. 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

Laryngoscope 2018 Dec 8. Epub 2018 Dec 8.

Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, Massachusetts, U.S.A.

Objectives/hypothesis: Although much is known about the incidence and risk factors for hemorrhage after tonsil surgery, the incidence and factors related to multiple episodes of hemorrhage are not well examined. Our objective was to identify risk factors that may contribute to multiple hemorrhages following tonsil surgery in children.

Study Design: Retrospective chart review. Read More

Front Pediatr 2018 23;6:342. Epub 2018 Nov 23.

Department of Pediatrics, Emory University, Atlanta, GA, United States.

Between 4 and 16% of extremely premature infants have late pulmonary hypertension (PH) (onset >30 days of life), and infants with PH have a higher risk of tracheostomy and death. Atrial septal defects (ASD) increase pulmonary blood flow and may promote PH in at-risk infants. The objective of this study was to determine if infants with ASD develop PH sooner than those without ASD. Read More

Hosp Pediatr 2019 Jan 10;9(1):6-15. Epub 2018 Dec 10.

Department of Pediatrics, School of Medicine and Public Health,

Objectives: Children with medical complexity (CMC) are commonly assisted by medical devices to support essential body functions, although complications may lead to preventable emergency department (ED) and hospital use. Our objective was to identify predictors of device-complicated ED visits and hospitalizations.

Methods: This single-center retrospective cohort study included patients referred to a Pediatric Complex Care Program between April 1, 2014, and April 30, 2016, assisted by at least 1 medical device. Read More

J Clin Sleep Med 2018 Dec 15;14(12):2079-2081. Epub 2018 Dec 15.

Division of Pediatric Pulmonology and Sleep Medicine, Children's Hospital Los Angeles, Los Angeles, California.

Abstract: 20/27 polyalanine repeat mutation (PARM) in patients with congenital central hypoventilation syndrome (CCHS) is generally associated with full-time ventilator dependence, Hirschsprung disease, and increased risk for cardiac asystole. We follow a 14-year-old boy with CCHS 20/27 PARM who is full-time ventilator dependent via tracheostomy and has Hirschsprung disease. His mother, age 52 years, has a history of prolonged recovery from anesthesia and an elevated serum bicarbonate level of 45 mEq/L discovered on routine blood chemistry. Read More

Pediatrics 2019 Jan 3;143(1). Epub 2018 Dec 3.

Children's Minnesota, Minneapolis, Minnesota.

: media-1vid110.1542/5849572914001PEDS-VA_2018-1951 BACKGROUND: An increasing proportion of pediatric hospital days are attributed to technology-dependent children. The impact that a pediatric home care nursing (HCN) shortage has on increasing length of hospital stay and readmissions in this population is not well documented. Read More

J Pediatr Nurs 2018 Nov - Dec;43:120-126. Epub 2018 Jun 30.

Boston Children's Hospital, USA.

Purpose: The purpose of this quality improvement project was to create a Tracheostomy Subject Matter Expert (Trach SME) Committee to standardize tracheostomy care, education, and the discharge process across Boston Children's Hospital.

Design And Methods: Boston Children's Hospital (BCH) is a free-standing urban tertiary pediatric hospital with 15 inpatient units. The newly formed Trach SME Committee evaluated the discharge process across the enterprise including hospital satellites and intra-hospital practice. Read More

Turk Pediatri Ars 2018 Sep 1;53(3):177-184. Epub 2018 Sep 1.

Unit of Pediatric Intensive Care, İzmir Tepecik Training and Research and Hospital, İzmir, Turkey.

Aim: We aimed to describe which clinical characteristics were associated with the outcome of tracheostomy in our tertiary care pediatric intensive care unit.

Material And Methods: This was a retrospective review of medical records of pediatric patients who underwent tracheostomy in our Pediatric Intensive Care unit from 2008 to 2014 in Turkey.

Results: Sixty-three patients were included the study. Read More

Laryngoscope 2018 Nov 19. Epub 2018 Nov 19.

Department of Otolaryngology, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, U.S.A.

Objectives: 1) Characterize the spectrum of airway anomalies in patients with craniosynostosis, and 2) identify clinical characteristics of these patients that may be associated with the development of airway anomalies.

Methods: This study is a retrospective case series assessing the type and frequency of airway anomalies in all patients with craniosynostosis seen at a tertiary-care children's hospital between 2000 and 2016. Cohort analyses were then performed to identify differences in airway anomalies dependent on syndromic associations, multisutural fusion, and location of suture fusion. Read More

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2018 Nov;53(11):825-829

Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.

To observe the clinical course of children with juvenile-onset recurrent respiratory papillomatosis (JORRP) until 14 years old. The clinical data of one hundred and twenty cases treated between Januray 1, 2002 and September 30, 2017 in Beijing Tongren Hospital were analyzed retrospectively. Excluding the deaths and the lost, patients who could be ≥ 5 years without recurrence, were defined as the cured group, and < 5 years with recurrence defined as the recurrent group. Read More

Paediatr Anaesth 2018 Dec 19;28(12):1129-1135. Epub 2018 Nov 19.

Department of Anaesthesia, Great Ormond Street Hospital for Children, London, UK.

Background: A tracheocutaneous fistula is a known complication following tracheostomy decannulation. Although surgical techniques for its repair are well described, there is no consensus about perioperative management and this procedure may generate significant airway and respiratory complications intraoperatively, and in the early postoperative period. We aimed to describe variations in perioperative management in tracheocutaneous fistula closure, estimate the incidence of early airway and respiratory complications, and identify any predisposing factors. Read More

Laryngoscope 2018 Nov 15. Epub 2018 Nov 15.

Department of Otolaryngology-Head and Neck Surgery, Division of Pediatric Otolaryngology, University of Texas Southwestern Medical Center, Dallas, Texas.

Objectives/hypothesis: To estimate the number, demographics, and outcomes of pediatric patients who underwent tracheostomy in 2012 and to contrast those outcomes by age, race, and gender.

Study Design: Cross-sectional study.

Methods: The 2012 Kids Inpatient Database was queried to identify tracheostomy patients using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) procedural codes 311, 3121, and 3129. Read More

J Pediatr Endocrinol Metab 2018 Dec;31(12):1343-1347

Department of Pediatrics, University of Torino, Torino, Italy.

Background With conventional enzyme replacement therapy (ERT), the clinical prognosis of classic Pompe disease is often unsatisfactory. About half the patients treated with ERT at the recommended dosage (20 mg/kg every other week) require ventilatory support within the first years of life. The heterogeneous response to ERT has been related to different factors, including cross-reactive immunologic material (CRIM) status and age at ERT initiation. Read More

Case Rep Pediatr 2018 9;2018:4701736. Epub 2018 Oct 9.

Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA.

Obstructive sleep apnea (OSA) is a common disorder in children but can occasionally present with life-threatening hypoxemia. Obesity is a significant risk factor for poor outcomes of OSA treatment. Continuous positive airway pressure (CPAP) is indicated in children who are not candidates for or have an unsatisfactory response to adenotonsillectomy. Read More

Clin Perinatol 2018 12 18;45(4):805-816. Epub 2018 Sep 18.

Ann & Robert H. Lurie Children's Hospital of Chicago, Box 25, 225 E Chicago Avenue, Chicago, IL 60611, USA.

Neonatal and infant tracheostomies have been valuable in the care and survival of children over the past century. With the implementation of neonatal and pediatric intensive care units, more infants are surviving conditions that were considered fatal. Neonatal tracheostomy plays a vital role in many of these conditions, with significant implications and association with overall mortality, morbidity, and developmental outcomes. Read More

Clin Perinatol 2018 12 27;45(4):787-804. Epub 2018 Aug 27.

Division of Pediatric Otolaryngology, Department of Otolaryngology-Head and Neck Surgery, MUSC Children's Hospital, Medical University of South Carolina, 135 Rutledge Avenue, MSC 550, Charleston, SC 29425, USA. Electronic address:

The subglottis is a narrow region of the pediatric airway that is exquisitely susceptible to the development of airway stenosis. The incidence of acquired subglottic stenosis in the setting of prolonged intubation has significantly decreased because of improved endotracheal tube management protocols. Advances in otolaryngology interventions, such as balloon dilation and endoscopic cricoid split techniques, may allow the avoidance of tracheostomy in patients with mild to moderate subglottic stenosis. Read More

Otolaryngol Clin North Am 2019 Feb;52(1):123-133

Department of Pediatric Otolaryngology, Nationwide Children's Hospital, 555 South 18th Street, Suite 2A, Columbus, OH 43205, USA; Department of Otolaryngology-Head and Neck Surgery, Wexner Medical Center at Ohio State University, 915 Olentangy River Road, Columbus, OH 43212, USA. Electronic address:

A Pediatric Tracheostomy Care Index (PTCI) was developed by the authors to standardize care and drive quality improvement efforts at their institution. The PTCI comprises 9 elements deemed essential for safe care of children with a tracheostomy tube. Based on the PTCI scores, the number of missed opportunities per patient was tracked, and interventions through a "Plan-Do-Study-Act" approach were performed. Read More

Crit Care Med 2019 Feb;47(2):e112-e119

Harborview Injury Prevention and Research Center, University of Washington, Seattle, WA.

Objectives: To evaluate morbidity and mortality among critically injured children with acute respiratory distress syndrome.

Design: Retrospective cohort study.

Setting: Four-hundred sixty Level I/II adult or pediatric trauma centers contributing to the National Trauma Data Bank. Read More

Eur J Clin Microbiol Infect Dis 2019 Jan 29;38(1):171-176. Epub 2018 Oct 29.

Department of Pediatrics, McMaster University, HSC-3A, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.

Children with medical complexity (CMC) are vulnerable to respiratory illness hospitalization (RIH) and respiratory syncytial virus (RSV)-related hospitalization (RSVH) due to multisystem disorders and compromised airways. It is unknown whether RSV prophylaxis is effective, or if RSVH is associated with significant morbidities in CMC. The study objectives were to (1) determine the incidence of RSV-related infection in prophylaxed CMC during the first 3 years of life and (2) assess the burden of illness following RSVH. Read More

Int J Pediatr Otorhinolaryngol 2018 Dec 18;115:49-53. Epub 2018 Sep 18.

Medical College of Wisconsin, Department of Otolaryngology, Milwaukee, WI, USA. Electronic address:

Introduction: Pediatric vocal cord paresis (VCP) has a variety of etiologies, including congenital neurologic disease. Arnold-Chiari Malformation (ACM) is one such disease with known VCP association. However, the natural history, need for tracheostomy, and rate of decannulation in this patient population is not well characterized. Read More

Int J Pediatr Otorhinolaryngol 2018 Dec 25;115:177-180. Epub 2018 Sep 25.

Division of Respiratory Medicine, Hospital for Sick Children, Department of Pediatrics, University of Toronto, Canada. Electronic address:

Objectives: To investigate variability in pediatric tracheostomy tube care practice patterns and access to resources across Canada.

Methods: Canadian pediatric otolaryngologists-head & neck surgeons reported their own practice patterns for children with chronic tracheostomy tubes using a web-based, 29-item multiple choice and short answer questionnaire. Domains investigated included tracheostomy team membership, inpatient care practices, caregiver education, homecare resources, speech and communication, and completeness of emergency tracheostomy kits. Read More

Int J Pediatr Otorhinolaryngol 2018 Dec 13;115:1-5. Epub 2018 Sep 13.

Anesthesiology and Critical Care Medicine, Department of Medicine, Division of Pediatric Critical Care Medicine, Johns Hopkins All Children's Hospital, Johns Hopkins University, 501 6th Street South, OCC Suite 702, Room 709, St. Petersburg, FL, 33701, USA. Electronic address:

Objective: To assess the frequency of post-procedural complications, medical interventions, and hospital costs associated with microlaryngobronchoscopy (MLB) in children prophylactically admitted for pediatric intensive care unit (PICU) monitoring for age ≤ 2 years.

Methods: We performed a single-center, retrospective, descriptive study within a 44-bed PICU in a stand-alone, tertiary, pediatric referral center. Inclusion criteria were age ≤2 years and pre-procedural selection of prophylactic PICU monitoring after MLB between January 2010 and December 2015. Read More

Int J Spine Surg 2018 Oct 15;12(5):611-616. Epub 2018 Oct 15.

Illinois Bone and Joint Institute, Chicago, Illinois.

Background: Instrumentation of the axis can be accomplished through a variety of techniques including transarticular screw fixation, pars and pedicle screw fixation, translaminar screw fixation, and posterior wiring. We report on the evolution of the axial 4-screw technique.

Methods: Retrospective case review. Read More

Pediatr Pulmonol 2018 Nov 24;53(11):1549-1558. Epub 2018 Sep 24.

Pediatric Pulmonary and Sleep Medicine, Medical College of Wisconsin, Milwaukee, WisconsinWisconsin.

Background The prevalence of respiratory-technology dependent children is increasing although for most children the goal is liberation from technology. Liberation from home mechanical ventilation (HMV) and decannulation strategies vary due to the lack of clinical practice standards. The primary objective of this study was to describe our practice utilizing a polysomnography (PSG) in the liberation from respiratory-technology process. Read More

Otolaryngol Head Neck Surg 2018 Oct 23:194599818808774. Epub 2018 Oct 23.

1 Division of Otolaryngology-Head and Neck Surgery, University of Utah, Salt Lake City, Utah, USA.

Objective: To review the presentation and treatment of children diagnosed with bacterial tracheitis at our institution and to review the available literature focusing on key presenting symptoms and clinical outcomes of children diagnosed with bacterial tracheitis.

Study Design: Case series with literature review.

Setting: Tertiary children's hospital and available literature. Read More

Otolaryngol Head Neck Surg 2018 Oct 23:194599818803598. Epub 2018 Oct 23.

1 College of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA.

Objectives: To investigate national and regional variations in pediatric tracheostomy rates, epidemiology, and outcomes from 2000 to 2012.

Study Design: Retrospective cohort analysis.

Setting: Previous research with the 1997 edition of the Kids' Inpatient Database (KID), a national database of pediatric hospital discharge data, demonstrated that rates and outcomes of pediatric tracheostomy vary among US geographic regions. Read More

Med Clin North Am 2018 Nov;102(6):1055-1061

Departments of Medicine and Pediatrics, Johns Hopkins University School of Medicine, 601 North Caroline Street, Suite 7143, Baltimore, MD 21287, USA.

Millions of adults in the United States are currently living with what is termed chronic childhood conditions-childhood-onset conditions, about which adult providers often receive minimal training-and another half million youths with special health care needs enter adulthood each year and will undergo transition from pediatric to adult care. Here, the authors review the important otolaryngologic manifestations of several of these chronic childhood conditions, including autism spectrum disorder, cerebral palsy, and Down syndrome, as well as the primary care providers' role in caring for transitioning tracheostomy-dependent patients. Read More

PLoS One 2018 19;13(10):e0206305. Epub 2018 Oct 19.

College of Medicine, The Ohio State University, and Nationwide Children's Hospital, Columbus, Ohio, United States of America.

Streptococcus pneumoniae colonization is a precursor to pneumococcal disease. Although children with a tracheostomy have an increased risk of pneumococcal pneumonia, the pneumococci colonizing their lower airways remain largely uncharacterized. We sought to compare lower respiratory tract isolates colonizing tracheostomy patients and a convenience sample of isolates from individuals intubated for acute conditions. Read More

Pediatr Neurol 2018 Dec 4;89:31-38. Epub 2018 Aug 4.

Oregon Health and Science University, Department of Pediatrics, Division of Pediatric Critical Care, Portland, Oregon.

Background: Disorders requiring pediatric neurocritical care (PNCC) affect thousands of children annually. We aimed to quantify the burden of PNCC through generation of national estimates of disease incidence, utilization of critical care interventions (CCI), and hospital outcomes.

Methods: We performed a retrospective cohort analysis of the Kids Inpatient Database over three years to evaluate pediatric traumatic brain injury, neuro-infection or inflammatory diseases, status epilepticus, stroke, hypoxic ischemic injury after cardiac arrest, and spinal cord injury. Read More

Laryngoscope 2018 Oct 16. Epub 2018 Oct 16.

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

Objectives: The aim of this study was to perform computational simulations of airflow within an anatomically accurate model of an adult trachea in different tracheostomy tube designs. We hypothesized that tracheal airflow in patients is significantly influenced by the geometry and size of these devices.

Methods: The three-dimensional (3D) geometry of the trachea was reconstructed using computed tomography scans for an adult with no history of lung disease. Read More