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        "resumen" => "<span id="as0005" class="elsevierStyleSection elsevierViewall"><p id="sp0005" class="elsevierStyleSimplePara elsevierViewall">Apesar dos avan&#231;os nas t&#233;cnicas de ventila&#231;&#227;o n&#227;o invasiva&#44; a traqueostomia continua a ter indica&#231;&#227;o em crian&#231;as com perturba&#231;&#227;o grave da via a&#233;rea ou com necessidade de ventila&#231;&#227;o prolongada&#46; Sendo um procedimento de execu&#231;&#227;o f&#225;cil&#44; n&#227;o &#233; isenta de riscos&#44; pelo que se justifica sempre a pondera&#231;&#227;o pr&#233;via de alternativas &#224; decis&#227;o de traqueostomizar&#46;</p><p id="sp1005" class="elsevierStyleSimplePara elsevierViewall">Foram objectivos deste estudo a identifica&#231;&#227;o das crian&#231;as traqueostomizadas com seguimento num servi&#231;o de pediatria de hospital terci&#225;rio&#44; a caracteriza&#231;&#227;o da doen&#231;a prim&#225;ria e indica&#231;&#245;es conducentes &#224; decis&#227;o de traqueostomizar e a avalia&#231;&#227;o das complica&#231;&#245;es registada neste grupo de doentes&#46;</p><p id="sp1105" class="elsevierStyleSimplePara elsevierViewall">Procedeu-se &#224; revis&#227;o dos processos cl&#237;nicos das dezasseis crian&#231;as traqueostomizadas&#44; com uma mediana de idade &#224; data da realiza&#231;&#227;o da traqueostomia de 4&#44;5 meses&#44; cinco com doen&#231;a neuromuscular&#44; tr&#234;s com paralisia cerebral e sete com doen&#231;a pulmonar ou das vias a&#233;reas&#46; A indica&#231;&#227;o para a traqueostomia foi a necessidade de ventila&#231;&#227;o invasiva prolongada em doze casos&#44; estenose subgl&#243;tica ou traqueal em tr&#234;s e laringomalacia num outro&#46; As complica&#231;&#245;es mais frequentes foram a coloniza&#231;&#227;o bacteriana persistente&#44; a descanula&#231;&#227;o transit&#243;ria acidental e a obstru&#231;&#227;o transit&#243;ria da c&#226;nula&#46; Verificou-se um &#243;bito relacionado com a traqueostomia&#46; Nove crian&#231;as mant&#234;m traqueostomia&#44; cinco foram descanuladas &#40;uma das quais veio a falecer&#41; e outras duas faleceram ainda com traqueostomia&#46;</p><p id="sp1115" class="elsevierStyleSimplePara elsevierViewall">Tal como sublinhado na literatura&#44; as crian&#231;as e adolescentes traqueostomizados t&#234;m habitualmente patologias m&#250;ltiplas que exigem apoio multidisciplinar&#46; A complexidade das situa&#231;&#245;es cl&#237;nicas e a exig&#234;ncia de recursos determinam a necessidade de acompanhamento em centro especializado de refer&#234;ncia&#46;</p><p id="sp0010" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Rev Port Pneumol 2009&#59; XV &#40;2&#41;&#58; 227-239</span></p></span>"
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        "resumen" => "<span id="as0010" class="elsevierStyleSection elsevierViewall"><p id="sp0015" class="elsevierStyleSimplePara elsevierViewall">Despite advances in non-invasive ventilation techniques&#44; tracheostomy is still indicated in children with serious airway obstruction or with the need for long-term ventilation&#46; Alternatives should be studied before deciding to tracheostomise as complications exist&#44; despite the simple procedure&#46;</p><p id="sp1125" class="elsevierStyleSimplePara elsevierViewall">The aims of this study were the identification of tracheostomised children followed in a tertiary care paediatric department&#44; the characterisation of primary disease&#44; the indications leading to tracheostomy and any complications&#46;</p><p id="sp0020" class="elsevierStyleSimplePara elsevierViewall">We present a case review of tracheostomised children followed in our department&#46;</p><p id="sp1135" class="elsevierStyleSimplePara elsevierViewall">Sixteen tracheostomised children were followed&#44; median age of 4&#46;5<span class="elsevierStyleHsp" style=""></span>months&#44; neuromuscular disease &#8211; 5&#44; cerebral palsy &#8211; 3 and pulmonary or airway disease &#8211; 7&#46; Indications were long-term invasive ventilation &#8211; 12&#44; subglottic or tracheal stenosis &#8211; 3 and laryngomalacia &#8211; 1&#46; The most frequent complications found were persistent bacterial colonisation&#44; accidental decannulation and obstruction&#46; There was a tracheostomy-related death in 1 child&#46; Outcome&#58; 9 children maintained tracheostomy&#44; 5 were successfully decannulated and 2 children died while on tracheostomy&#46;</p><p id="sp1145" class="elsevierStyleSimplePara elsevierViewall">Tracheostomised children usually have complex disease that requires a multidisciplinary team and should be followed-up at a specialised reference centre&#46;</p><p id="sp0025" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Rev Port Pneumol 2009&#59; XV &#40;2&#41;&#58; 227-239</span></p></span>"
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                              5 => "F&#46;J&#46; Berchi"
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                          ]
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                          "fecha" => "1997"
                          "volumen" => "10"
                          "numero" => "1"
                          "paginaInicial" => "38"
                          "paginaFinal" => "41"
                          "link" => array:1 [
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                          "paginaFinal" => "53"
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                          "volumen" => "129"
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                          "paginaFinal" => "1271"
                          "link" => array:1 [
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                          "paginaFinal" => "699"
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                          "paginaFinal" => "1562"
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                          "paginaFinal" => "308"
                          "link" => array:1 [
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                          "numero" => "Suppl 23"
                          "paginaInicial" => "135"
                          "paginaFinal" => "136"
                          "link" => array:1 [
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Vol. 15. Issue 2.
Pages 227-239 (March - April 2009)
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Vol. 15. Issue 2.
Pages 227-239 (March - April 2009)
Artigo Original/Original Article
Open Access
Traqueostomia: Indicações e complicações em doentes pediátricos
Tracheostomy: Indications and complications in paediatric patients
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6128
Artur Sousa1, Teresa Nunes2,
Corresponding author
teresanunes@sapo.pt

Correspondência / Correspondence to: Teresa Nunes Unidade de Pneumologia, Clínica Universitária de Pediatria, Hospital de Santa Maria, Lisboa
, Rosa Roque Farinha3, Teresa Bandeira4
1 Interno do internato complementar de pediatria do Hospital de Santa Maria / Resident, Paediatrics, Hospital de Santa Maria
2 Assistente hospitalar do Departamento da Criança e da Família do Hospital de Santa Maria, assistente da Clínica Universitária de Pediatria da Faculdade de Medicina de Lisboa / Consultant, Family and Child Unit, Hospital de Santa Maria; Consultant, University Paediatrics Clinic, Lisbon University Faculty of Medicine
3 Assistente hospitalar graduada do Serviço de Otorrinolaringologia do Hospital de Santa Maria, professora auxiliar coordenadora da disciplina de Otorrinolaringologia da Faculdade de Medicina da Universidade da Beira Interior / Consultant, ENT Specialist, Hospital de Santa Maria; Assistant Professor, Coordinator ENT, Beira Interior University Faculty of Medicine
4 Assistente hospitalar graduada do Departamento da Criança e da Família do Hospital de Santa Maria, assistente da Clínica Universitária de Pediatria da Faculdade de Medicina de Lisboa / Consultant, Specialist, Family and Child Unit, Hospital de Santa Maria; Consultant, University Paediatrics Clinic, Lisbon University Faculty of Medicine
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Resumo

Apesar dos avanços nas técnicas de ventilação não invasiva, a traqueostomia continua a ter indicação em crianças com perturbação grave da via aérea ou com necessidade de ventilação prolongada. Sendo um procedimento de execução fácil, não é isenta de riscos, pelo que se justifica sempre a ponderação prévia de alternativas à decisão de traqueostomizar.

Foram objectivos deste estudo a identificação das crianças traqueostomizadas com seguimento num serviço de pediatria de hospital terciário, a caracterização da doença primária e indicações conducentes à decisão de traqueostomizar e a avaliação das complicações registada neste grupo de doentes.

Procedeu-se à revisão dos processos clínicos das dezasseis crianças traqueostomizadas, com uma mediana de idade à data da realização da traqueostomia de 4,5 meses, cinco com doença neuromuscular, três com paralisia cerebral e sete com doença pulmonar ou das vias aéreas. A indicação para a traqueostomia foi a necessidade de ventilação invasiva prolongada em doze casos, estenose subglótica ou traqueal em três e laringomalacia num outro. As complicações mais frequentes foram a colonização bacteriana persistente, a descanulação transitória acidental e a obstrução transitória da cânula. Verificou-se um óbito relacionado com a traqueostomia. Nove crianças mantêm traqueostomia, cinco foram descanuladas (uma das quais veio a falecer) e outras duas faleceram ainda com traqueostomia.

Tal como sublinhado na literatura, as crianças e adolescentes traqueostomizados têm habitualmente patologias múltiplas que exigem apoio multidisciplinar. A complexidade das situações clínicas e a exigência de recursos determinam a necessidade de acompanhamento em centro especializado de referência.

Rev Port Pneumol 2009; XV (2): 227-239

Palavras-chave:
Traqueostomia
criança
complicações
indicações
Abstract

Despite advances in non-invasive ventilation techniques, tracheostomy is still indicated in children with serious airway obstruction or with the need for long-term ventilation. Alternatives should be studied before deciding to tracheostomise as complications exist, despite the simple procedure.

The aims of this study were the identification of tracheostomised children followed in a tertiary care paediatric department, the characterisation of primary disease, the indications leading to tracheostomy and any complications.

We present a case review of tracheostomised children followed in our department.

Sixteen tracheostomised children were followed, median age of 4.5months, neuromuscular disease – 5, cerebral palsy – 3 and pulmonary or airway disease – 7. Indications were long-term invasive ventilation – 12, subglottic or tracheal stenosis – 3 and laryngomalacia – 1. The most frequent complications found were persistent bacterial colonisation, accidental decannulation and obstruction. There was a tracheostomy-related death in 1 child. Outcome: 9 children maintained tracheostomy, 5 were successfully decannulated and 2 children died while on tracheostomy.

Tracheostomised children usually have complex disease that requires a multidisciplinary team and should be followed-up at a specialised reference centre.

Rev Port Pneumol 2009; XV (2): 227-239

Key-words:
Tracheostomy
child
complications
indications
Full text is only aviable in PDF
Bibliografia/Bibliography
[1.]
E. Jardine, M. O’Toole, J.Y. Paton, et al.
Current status of long term ventilation of children in the United Kingdom: questionnaire survey.
BMJ, 318 (1999), pp. 295-299
[2.]
E.A. Edwards, M. O’Toole, C. Wallis.
Sending children home on tracheostomy dependent ventilation: pitfalls and outcomes.
Arch Dis Child, 89 (2004), pp. 251-255
[3.]
David TN, Bandeira T, Félix M, Estevão MH. Ventilação de longa duração em pediatria – inquérito nacional. Dados não publicados.
[4.]
R.S. Amin, C.M. Fitton.
Tracheostomy and home ventilation in chidren.
Semin Neonatol, 8 (2003), pp. 127-135
[5.]
H. Ramalho, E. Proença, P. Ferreira, M.B. Coutinho, A. Vilarinho.
Traqueostomia na criança. Experiência do Hospital de Crianças Maria Pia.
Acta Pediatr Port, 30 (1999),
[6.]
M.A. Jimenez Isabel, J.A. Matute Cardenas, M.D. Delgado Munoz, P. Aguardo Roncero, M.A. Villafruela, F.J. Berchi.
Surgical treatment versus tracheostomy of the laryngeal stenosis in children.
Cir Pediatr, 10 (1997), pp. 38-41
[7.]
E. Fiske.
Effective strategies to prepare infants and famillies for home tracheostomy care.
Adv Neonatal Care, 4 (2004), pp. 42-53
[8.]
K.D. Pereira, A.R. MacGregor, C.M. McDuffie, R.B. Mitchell.
Tracheostomy in preterm infants.
Arch Otolaryngol Head Neck Surg, 129 (2003), pp. 1268-1271
[9.]
R.F. Welmore, R.R. Marsh, M.E. Thompson, L.W. Tom.
Pediatric tracheostomy: a changing procedure?.
Ann Otol Rhinol Laryngol, 108 (1999), pp. 695-699
[10.]
B. Kremer, A.I. Botos-Kremer, H.E. Eckel, G. Schlondorff.
Indications, complications, and surgical techniques for pediatric tracheostomies – An update.
J Pediatr Surg, 37 (2002), pp. 1556-1562
[11.]
American Thoracic Society.
Care of the child with a chronic tracheostomy.
Am J Respir Crit Care Med, 161 (2000), pp. 297-308
[12.]
J.P. Lindmann, C.E. Morgan.
Tracheostomy.
[13.]
B. Estournet-Mathiaud.
Tracheostomy in chronic lung disease: Care and follow-up.
Pediatr Pulmonol, (2001), pp. 135-136
[14.]
A. Alladi, S. Rao, K. Das, A.R. Charles, A.J. D’Cruz.
Pediatric tracheostomy: a 13 year experience.
Pediatr Surg Int, 20 (2004), pp. 695-698
Copyright © 2009. Sociedade Portuguesa de Pneumologia/SPP
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