Indications for tracheostomy in paediatric patients at a tertiary referral centre, Inkosi Albert Luthuli Hospital (IALCH).
Kissi., Phumelele Bongiwe Nokwazi.
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The paediatric tracheostomy is an uncommon procedure, with higher mortality and morbidity rates than the adult tracheostomy. The procedure itself is technically more demanding than in adults due to the smaller more pliable trachea and the limited operatingfield. The paediatric tracheostomy is performed with a different technique than that of an adult tracheostomy, with a formal stoma is fashioned by suturing the tracheal wall to the skin with maturation sutures in addition to safety stay sutures placed in the tracheal wall. The considerations include the growing anatomy of a child and attention is placed on preventing accidental decannulation and preventing long term damage to the growing anatomy of a child. With the increased availability of Paediatric intensive Care Units (PICU), and high trauma burden in children in Durban, South Africa, we plan to determine what the most common indication for performing a tracheostomy in a paediatric population. This will be done by a retrospective chart review of all cases requiring tracheostomy at IALCH between the period of 2004 to 2016. An in-depth analysis of the charts will provide insight in to the most common pathology requiring a tracheostomy and with that knowledge we can add value to the existing Paediatric tracheostomy Care programme at IALCH. This information gathered will further assist in establishing a support system for the parents of a child with a tracheostomy.