[Clinical experience in home care of children with tracheostomy].

BACKGROUND: Home care of tracheostomized children is considered a safe and low-cost alternative.

AIM: To report the experience with tracheostomized children at the Pediatric Respiratory Unit of the Catholic University Hospital.

PATIENTS AND METHODS: The records of 16 children (9 male) with tracheostomy (TQ) in home care between 1992 and 1998 were reviewed.

RESULTS: The average age at the moment of TQ was 9 months (range 1-30 months) and the postoperative hospital management period was 5 months (range 1-11 months). The average age at discharge was 13 months (range 3 to 30 months). Surgical indication were upper airway obstruction (congenital or acquired subglottic stenosis in three, upper airway malformations in one, vocal cord palsy in one and tracheobronchomalacia in one) and chronic assisted ventilation (severe tracheobronchomalacia in four, pulmonary hypoplasia in two, myopathy in one, central nervous injury in one and bronchopulmonary dysplasia in one). Overall rate complications were 2 per 100 tracheostomy months during home care and 8 per 100 tracheostomy months during hospital care. No tracheostomy-related deaths were observed. A parenteral education program to teach about tracheostomy management and cardiopulmonary resuscitation was carried out.

CONCLUSIONS: Tracheostomized children can be safely managed at home.