Share This

Paediatric tracheostomy is usually an essential procedure to preserve life, or to allow a patient to function in the community. However, the effect of tracheostomy on the developing child - care requirements, lack of voice, impaired swallow, constant risk of decannulation or blockage and so forth - have profound effects that are inadequately understood. This study from Sheffield looks at 25 families (about a third of those eligible) with children with tracheostomies (or recently decannulated). The age range of patients follows that of clinic practice, with a predominance of younger children. All indications for tracheostomy were included, from those requiring continuous ventilation to those with pharyngeal airway obstruction and those with glottic and subglottic stenosis. Age-specific quality of life measures looking at social, emotional, physical and cognitive functioning were used, with children encouraged to self-report their opinions where possible.

The outcomes show worse quality of life than the normal population, which could be expected, but also a worse quality of life than comparable chronic diseases. The authors particularly consider childhood malignancy, type 1 diabetes, and renal failure requiring dialysis – all of which have comparable or even greater care requirements and impacts on health in the long term.

This fascinating finding emphasises the particular effects that tracheostomy has in a child – specifically social isolation. The authors recommend psychosocial support for such patients to be provided routinely, and after reading this article it is hard to disagree.

Quality of life in paediatric tracheostomy patients and their caregivers - A cross-sectional study.
Westwood EL, Hutchins JV, Thevasagayam R.
Share This
Robert Nash

BM BCh, MA(Oxon), MRCS, MA, DOHNS, FRCS (ORL-HNS), Great Ormond Street Hospital, London, UK.

View Full Profile