Characteristics of tracheostomized patients followed up by a Palliative Care and Complex Chronic Patient Service

• Published in: Anales de Pediatría 2024-04, Vol.100 (4), p.251-258
• Main Authors: Pons-Tomàs, Gemma, Painamil, Rodrigo Morales, Campos, Sílvia Ricart, Arasa, Eduard Pellicer, Sanflorencio, Lucía Peñarrubia, Corredor, Laura Ponce, López, Isabel Torrús
• Format: Article
• Language: English
• Subjects: Infecciones respiratorias; Paediatrics; Pediatría; Respiratory tract infections; Tracheostomy; Tracheotomy; Traqueostomía; Traqueotomía
• ISSN: 2341-2879; 2341-2879
• DOI: 10.1016/j.anpede.2024.03.010

[Display omitted] In recent years, there has been an increase in the number of children with tracheostomies. The objective was to describe the characteristics of paediatric patients with a tracheostomy followed up by the Department of Palliative Care and Chronic Medically Complex Illness (DPCCMCI) of a tertiary care hospital. Single-centre retrospective observational study in patients aged less than 18 years with a tracheostomy followed up by the PCCCPS of a tertiary care hospital (November 2020-June 2022). We analysed epidemiological, clinical, microbiological and social data by reviewing the health records. The sample included 44 tracheostomized patients. The most frequent underlying disease was acquired upper airway disease (20.5%). The most common indication for tracheostomy was upper airway obstruction (66%). Bacterial isolates were detected in 84% of the tracheal aspirates, among which P. aeruginosa was the most frequent (56.8%). The most frequently prescribed antibiotic was ciprofloxacin (84%). In addition, 18.1% of the patients received at least 1 course of intravenous antibiotherapy and 29.5% received more than 3 systemic antibiotic regimens in the past 20 months. Fifty-nine percent of the children were schooled: 38.6% attended a regular school, 15.9% a special needs school and 4.5% were home-schooled. We identified social difficulties in 53.7%. Also, 22.7% of the families received financial support to care for a child with severe illness. Because of the complexity of caring for tracheostomized children, integral and coordinated management is essential. Schooling is possible and safe if caregivers are trained. En los últimos años se ha objetivado un incremento de niños portadores de traqueostomía. El objetivo del estudio es describir las características de los pacientes pediátricos traqueostomizados en seguimiento por el SAPPCC de un hospital de tercer nivel. Estudio unicéntrico, observacional y retrospectivo que incluyó pacientes ≤18 años portadores de traqueostomía atendidos por el SAPPCC de un hospital de tercer nivel (noviembre 2020-junio 2022). Se analizaron datos epidemiológicos, clínicos, microbiológicos y sociales mediante la revisión de la historia clínica. Se incluyeron 44 pacientes traqueostomizados. La patología de base más frecuente fue la patología de vía aérea superior adquirida (20,5%), siendo la obstrucción de vía aérea superior (66%) la indicación más frecuente de traqueostomía. El 84% presentaron aislamientos bacterianos en aspi