Chronic tracheostomy care of ventilator-dependent and -independent children: Clinical practice patterns of pediatric respirologists in a publicly funded (Canadian) healthcare system

被引：8

作者：

St-Laurent, Aaron ^{[1
]}

Zielinski, David ^{[2
,3
]}

Qazi, Adam ^{[4
]}

AlAwadi, Aceel ^{[5
]}

Almajed, Athari ^{[5
]}

Adamko, Darryl J. ^{[6
]}

Alabdoulsalam, Tareq ^{[7
]}

Chiang, Jackie ^{[4
]}

Derynck, Michael ^{[8
]}

Gerdung, Chris ^{[9
]}

Kam, Karen ^{[10
]}

Katz, Sherri L. ^{[11
,12
]}

MacLusky, Ian ^{[11
]}

Mehta, Kevan ^{[13
]}

Mateos, Dimas ^{[14
]}

Nguyen, The Thanh D. ^{[15
]}

Praud, Jean-Paul ^{[16
]}

Proulx, Frederic ^{[17
]}

Seear, Michael ^{[18
]}

Smith, Mary Jane ^{[19
]}

Wensley, David ^{[18
]}

Amin, Reshma ^{[4
]}

机构：

[1] London Hlth Sci Ctr, Dept Paediat, Div Resp Med, Childrens Hosp, 800 Commissioners Rd E, London, ON N6A 5W9, Canada

[2] McGill Univ, Dept Pediat, Div Pediat Respirol, Montreal Childrens Hosp, Montreal, PQ, Canada

[3] McGill Univ, Res Inst, Hlth Ctr, Montreal, PQ, Canada

[4] Hosp Sick Children, Dept Pediat, Div Resp Med, Toronto, ON, Canada

[5] Mubarak Al Kabeer Hosp, Minist Hlth Kuwait, Jabriya, Kuwait

[6] Jim Pattisons Childrens Hosp, Dept Pediat, Div Resp Med, Saskatoon, SK, Canada

[7] Univ Manitoba, Dept Pediat & Child Hlth, Sect Pediat Respirol, HSC Winnipeg Childrens Hosp, Winnipeg, MB, Canada

[8] Queens Univ, Dept Pediat, Kingston Hlth Sci Ctr, Kingston, ON, Canada

[9] Univ Alberta, Stollery Childrens Hosp, Dept Pediat, Div Resp Med, Edmonton, AB, Canada

[10] Alberta Childrens Prov Gen Hosp, Dept Pediat, Sect Resp Med, Calgary, AB, Canada

[11] Univ Ottawa, Dept Pediat, Div Resp Med, Childrens Hosp Eastern Ontario, Ottawa, ON, Canada

[12] Eastern Ontario Res Inst, Childrens Hosp, Ottawa, ON, Canada

[13] McMaster Childrens Hosp, Dept Pediat, Div Respirol, Hamilton, ON, Canada

[14] IWK Hlth Ctr, Dept Pediat Pediat Respirol, Halifax, NS, Canada

[15] CHU St Justine, Div Respirol, Dept Pediat, Montreal, PQ, Canada

[16] Univ Sherbrooke, Dept Pediat, Div Resp Med, Sherbrooke, PQ, Canada

[17] CHUL & Ctr Mere Enfant Soleil, Dept Pediat, Div Respirol, Quebec City, PQ, Canada

[18] Univ British Columbia, Dept Pediat, Div Pediat Resp Med, Vancouver, BC, Canada

[19] Mem Univ Newfoundland, Fac Med, Dept Pediat, St John, NL, Canada

来源：

PEDIATRIC PULMONOLOGY | 2023年 / 58卷 / 01期

关键词：

chronic ventilation; decannulation; pediatric; speaking valve; tracheostomy; HOME MECHANICAL VENTILATION; PATIENT SAFETY; DECANNULATION; MANAGEMENT; EDUCATION; OUTCOMES; POLYSOMNOGRAPHY; IMPLEMENTATION; CAREGIVERS; REDUCTION;

D O I：

10.1002/ppul.26171

中图分类号：

R72 [儿科学];

学科分类号：

100202 ;

摘要：

Objectives To describe the current clinical practice patterns of Canadian pediatric respirologists at pediatric tertiary care institutions regarding chronic tracheostomy tube care and management of home invasive ventilation. Methods A pediatric respirologist/pediatrician with expertise in tracheostomy tube care and home ventilation was identified at each Canadian pediatric tertiary care center to complete a 59-item survey of multiple choice and short answer questions. Domains assessed included tracheostomy tube care, caregiver competency and home monitoring, speaking valves, medical management of tracheostomy complications, decannulation, and long-term follow-up. Results The response rate was 100% (17/17) with all Canadian tertiary care pediatric centers represented and heterogeneity of practice was observed in all domains assessed. For example, though most centers employ Bivona (TM) (17/17) and Shiley (TM) (15/17) tracheostomy tubes, variability was observed around tube change, re-use, and cleaning practices. Most centers require two trained caregivers (14/17) and recommend 24/7 eyes on care and oxygen saturation monitoring. Discharge with an emergency tracheostomy kit was universal (17/17). Considerable heterogeneity was observed in the timing and use of speaking valves and speech-language assessment. Inhaled anti-pseudomonal antibiotics are employed by most centers (16/17) though the indication, agent, and protocol varied by center. Though decannulation practices varied considerably, the requirement of upper airway patency was universally required to proceed with decannulation (17/17) independent of ongoing ventilatory support requirements. Conclusion Considerable variability in pediatric tracheostomy tube care practice exists across Canada. These results will serve as a starting point to standardize and evaluate tracheostomy tube care nationally.

引用

页码：140 / 151

页数：12

共 2 条

[1] Tracheostomy care: Clinical practice patterns of pediatric otolaryngologists-head and neck surgeons in a publicly funded (Canadian) health care system
Rai, Sunita K.
Holler, Theresa
Propst, Evan J.
Wolter, Nikolaus E.
Amin, Reshma
[J]. INTERNATIONAL JOURNAL OF PEDIATRIC OTORHINOLARYNGOLOGY, 2018, 115 : 177 - 180
[2] Airway multidrug-resistant organisms in a population of tracheostomy and chronic ventilator-dependent children at a tertiary care pediatric hospital
Havens, Tara N.
Rosen, David A.
Rivera-Spoljaric, Katherine
[J]. PEDIATRIC PULMONOLOGY, 2023, 58 (01) : 26 - 34

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