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    Tracheostomy Care: Physiology

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    rajirajesh
    Tracheostomy care involves the surgical creation of an opening in the trachea to facilitate breathing and ventilation support. The first successful tracheostomy was performed in the 15th century to relieve airway obstruction from enlarged tonsils. Infants have anatomical differences that make tracheostomy care more complex, such as a higher positioned larynx and softer cartilage. Tracheostomies are now commonly performed in children with prolonged ventilation needs, upper airway anomalies, or chronic conditions requiring long-term airway management. Bacterial infections were historically a leading cause of airway issues requiring tracheostomy but modern indications are more often prolonged intubation or structural airway abnormalities.

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    Tracheostomy Care: Physiology

    Uploaded by

    rajirajesh
    137 views2 pages
    Tracheostomy care involves the surgical creation of an opening in the trachea to facilitate breathing and ventilation support. The first successful tracheostomy was performed in the 15th century to relieve airway obstruction from enlarged tonsils. Infants have anatomical differences that make tracheostomy care more complex, such as a higher positioned larynx and softer cartilage. Tracheostomies are now commonly performed in children with prolonged ventilation needs, upper airway anomalies, or chronic conditions requiring long-term airway management. Bacterial infections were historically a leading cause of airway issues requiring tracheostomy but modern indications are more often prolonged intubation or structural airway abnormalities.

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    tracheostomy care

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    Tracheostomy care involves the surgical creation of an opening in the trachea to facilitate breathing and ventilation support. The first successful tracheostomy was performed in the 15th century to relieve airway obstruction from enlarged tonsils. Infants have anatomical differences that make tracheostomy care more complex, such as a higher positioned larynx and softer cartilage. Tracheostomies are now commonly performed in children with prolonged ventilation needs, upper airway anomalies, or chronic conditions requiring long-term airway management. Bacterial infections were historically a leading cause of airway issues requiring tracheostomy but modern indications are more often prolonged intubation or structural airway abnormalities.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    137 views2 pages

    Tracheostomy Care: Physiology

    Uploaded by

    rajirajesh
    Tracheostomy care involves the surgical creation of an opening in the trachea to facilitate breathing and ventilation support. The first successful tracheostomy was performed in the 15th century to relieve airway obstruction from enlarged tonsils. Infants have anatomical differences that make tracheostomy care more complex, such as a higher positioned larynx and softer cartilage. Tracheostomies are now commonly performed in children with prolonged ventilation needs, upper airway anomalies, or chronic conditions requiring long-term airway management. Bacterial infections were historically a leading cause of airway issues requiring tracheostomy but modern indications are more often prolonged intubation or structural airway abnormalities.

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    TRACHEOSTOMY CARE

    INTRODUCTION
    Over the last decade, tracheostomy has been increasingly performed in children
    with complex and chronic conditions, for management of upper-airway obstruction,
    prolonged ventilation, abnormal ventilatory drive, and irreversible neuromuscular
    conditions. The Italian physician Antonio Musa Brassolva performed the first reported
    successful tracheostomy in the early 15th century for relief of airway obstruction
    secondary to enlarged tonsils.
    ANATOMY AND PHYSIOLOGY
    Infants have shorter and fatter necks than adults. The infant larynx is situated more
    superior and anterior in the neck at the level of the third or fourth cervical vertebra, and it
    starts to descend at around 2 y of age. Its size is approximately one third that of the adult
    larynx. The adult larynx is positioned at the sixth or seventh vertebra. The hyoid
    frequently overlies the thyroid cartilage notch, making palpation of anatomic landmarks
    difficult at times. The infant thyrohyoid membrane is also much shorter. The cricoid
    cartilage is the narrowest part of the airway in a child; in adults, it is the vocal cords

    Physiology:

    The cartilages of the infant larynx are softer and more pliable than in adults, with a
    tendency to collapse if pressure is placed on them. The mucosa of the supraglottis and
    subglottis are lax in infants and thus more prone to edema when inflamed or injured.

    DEFINITION
    A tracheostomy is a surgical opening into the trachea below the larynx through
    which an indwelling tube is placed to overcome upper airway obstruction, facilitate
    mechanical ventilator support and/or the removal of tracheo-bronchial secretions.
    Tracheostomy is a surgical opening between 2 - 3 ( or 3 - 4) tracheal rings into the
    trachea below the larynx
    INDICATION OF TRACHEOSTOMY
    1. Bacterial infections
    Acute viral and bacterial infections, such as croup, diphtheria, and epiglottitis,
    were the leading causes of airway compromise leading to pediatric tracheostomy
    2. Upper airway anomalies
    Tracheostomy is now frequently performed in children who have upper-airway
    anomalies (either congenital or more commonly acquired secondary to prolonged
    intubation) or need prolonged mechanical ventilation due to respiratory failure
    3. Chronic disease management
    Tracheostomy is also performed more frequently in children with chronic conditions,
    including neurological impairment, and congenital heart and lung disease
    The upper airway obstruction of infectious origin was the main reason for which children
    were submitted to tracheostomy, most of the time in an emergency basis. Today, the main
    indications are: prolonged orotracheal intubation (OTI), upper airway obstruction caused
    by craniofacial malformations (such as the Robin's sequence, Treacher-Collins syndrome,
    Beckwith-Wiedemann syndrome, Nager syndrome and the CHARGE association),
    laryngotracheal stenosis and hypoventilation associated with neurologic disorders, such
    as brain palsy4. Since the survival of children with these congenital and neurological
    disorders is on the rise, a greater number of tracheostomies are being done in such
    population.

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