Tracheotomy Category

Our observational cohort study demonstrated that the placement of tracheotomy did achieve its clinical goal, ie, although practically all children with tracheotomies were colonized, they suffered significantly fewer infections (one of four patients). Some physicians may argue that this infection rate of 27% does not justify preventative interventions. Although the main problem was of primary […]

The prophylactic strategy of selective decontamination of the digestive tract (SDD) is based on the classification using the carrier state. The most important feature of SDD is the use of a combination of carefully selected nonabsorbable antimicrobials polymyxin, tobramycin, and amphotericin B These are given topically to the oropharynx and GI tract to prevent or […]

The adult and pediatric populations differ in their PPMs colonizing and infecting the lower airways. The few adult longitudinal tracheotomy studies using serial paired surveillance and diagnostic samples invariably report colonization and infection by aerobic Gram-negative bacilli. Our study shows that half of all exogenous colonization and infection episodes in children with tracheotomy are caused […]

A total of 66 episodes of colonization and/or infection were diagnosed in 21 of the 22 children admitted to the PICU who subsequently received a tracheotomy. There were 23 episodes (15 of colonization and 8 of infection) in 15 children receiving ventilation via a transtracheal tube, while 43 episodes (34 of colonization and 9 of […]

From one patient (patient 8), lower airway secretions were not taken before the tracheotomy; otherwise data collection was complete. This patient did not develop a lower airway infection preoperatively. Taking this into account, the statistical analysis was based on 21 patients, in the transtracheally intubated group, while data were complete for all 22 patients in […]

Percentage of Patients Colonized and/or Infected: This was calculated by obtaining the total number of patients who developed one or more episodes of colonization or infection during the two study episodes pretracheotomy and posttracheotomy, and dividing by the total number of patients enrolled in each episode X100. Incidence of Infection Episodes per 1,000 Ventilation Days: […]

All tracheotomies were performed electively using the routine methods employed in children by most authorities. The immediate aftercare, including daily stoma care, suctioning, and change of tracheotomy tube, was done under strict protocols of hygiene and sterility. Antibiotic Policy During the Study No prophylaxis was implemented at any stage during both episodes of artificial ventilation. […]