Choosing a paediatric tracheostomy tube: an update on current practice

2007 ◽  
Vol 122 (2) ◽  
pp. 161-169 ◽  
Author(s):  
D J Tweedie ◽  
C J Skilbeck ◽  
L A Cochrane ◽  
J Cooke ◽  
M E Wyatt
Keyword(s):  
Tracheostomy Tube ◽  
Current Practice ◽  
Small Range ◽  
Street Hospital ◽  
Great Ormond Street Hospital ◽  
Tracheostomy Tubes

AbstractObjectives:A variety of paediatric tracheostomy tubes are available. This article reviews those in current use at Great Ormond Street Hospital.Methods:We outline our preferences and the particular indications for the different tubes, speaking valves and other attachments.Results:Practice has changed significantly in recent years. One product has been re-sized by its manufacturer; others are no longer commonly used. An updated sizing chart is included for reference purposes, together with manufacturers' contact details.Conclusions:The choice of paediatric tracheostomy tube is driven by clinical requirements. A small range of tubes are suitable for the majority of children, but some will require other varieties in specific circumstances.

Paediatric tracheostomy tubes: recent developments and our current practice

2018 ◽  
Vol 132 (11) ◽  
pp. 961-968 ◽  
Author(s):  
D J Tweedie ◽  
J Cooke ◽  
K A Stephenson ◽  
S L Gupta ◽  
C M Pepper ◽  
...  
Keyword(s):  
Tracheostomy Tube ◽  
Current Practice ◽  
Small Range ◽  
Street Hospital ◽  
Children's Hospital ◽  
Great Ormond Street Hospital ◽  
Design Changes ◽  
Children’S Hospital ◽  
Recent Developments ◽  
Tracheostomy Tubes

AbstractObjectiveA variety of paediatric tracheostomy tubes are available. This article reviews the tubes in current use at Great Ormond Street Hospital for Children and Evelina London Children's Hospital.MethodsThis paper outlines our current preferences, and the particular indications for different tracheostomy tubes, speaking valves and other attachments.ResultsOur preferred types of tubes have undergone significant design changes. This paper also reports further experience with certain tubes that may be useful in particular circumstances. An updated sizing chart is included for reference purposes.ConclusionThe choice of a paediatric tracheostomy tube remains largely determined by individual clinical requirements. Although we still favour a small range of tubes for use in the majority of our patients, there are circumstances in which other varieties are indicated.

2 GOSHPODS: paediatric educational podcast series from great ormond street hospital

2021 ◽  
Author(s):  
Sara Cooke ◽  
Sara Warraich ◽  
Jeroen Poisson ◽  
Simon Blackburn ◽  
Abhimanu Lall
Keyword(s):  
Street Hospital ◽  
Great Ormond Street Hospital

Incidence and determinants of malpositioning tracheostomy tubes in critically ill adult patients

2021 ◽  
pp. 0310057X2110392
Author(s):  
Prakkash P Ananthan ◽  
Kwok M Ho ◽  
Matthew H Anstey ◽  
Bradley A Wibrow
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Tracheostomy Tube ◽  
Clinical Audit ◽  
Internal Diameter ◽  
Air Leak ◽  
Common Cause ◽  
Factors Associated ◽  
Tracheal Stoma ◽  
Tracheostomy Tubes

Tracheostomy tubes are chosen primarily based on their internal diameter; however, the length of the tube may also be important. We performed a prospective clinical audit of 30 critically ill patients following tracheostomy to identify the type of tracheostomy tube inserted, the incidence of malpositioning and the factors associated with the need to change the tracheostomy tube subsequently. Anthropometric neck measurements, distance between the skin and tracheal rings and the position of the tracheostomy cuff relative to the tracheal stoma were recorded and analysed. Malpositioning of the tracheostomy tube was noted in 20%, with a high riding cuff being the most common cause of malpositioning, resulting in an audible leak and a need to change the tracheostomy tube subsequently. A high riding cuff was more common when a small tracheostomy tube (e.g. Portex (Smiths Medical Australasia, Macquarie Park, NSW) ≤8.0 mm internal diameter with length <7.5 cm) was used, with risk further increased when the patient’s skin to trachea depth was greater than 0.8 cm. Identifying a high riding cuff relative to the tracheal stoma confirmed by a translaryngeal bronchoscopy strongly predicted the risk of air leak and the need to change the tracheostomy tube subsequently. Our study suggests that when a small (and short) tracheostomy tube is planned for use, intraoperative translaryngeal bronchoscopy is warranted to exclude malpositioning of the tracheostomy tube with a high riding cuff.

My Name Was Charlie Gard

2017 ◽  
Vol 42 (11) ◽  
pp. 1-4
Author(s):  
Gerald D. Coleman ◽  
Keyword(s):  
Intensive Care Unit ◽  
Mitochondrial Dna ◽  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Genetic Condition ◽  
Street Hospital ◽  
Great Ormond Street Hospital ◽  
Sufficient Energy ◽  
Mitochondrial Dna Depletion ◽  
Mitochondrial Dna Depletion Syndrome

My name was Charles Gard, but everyone called me Charlie. I was eleven months old when my parents decided to end a contentious legal fight and allow me to die. I was born in West London on August 4, 2016. My dad, Chris, is a postman and my mom’s name is Connie. They are still young, only in their thirties. At birth, I seemed to be developing normally, but by October, it was apparent that I was not gaining weight. I was then admitted to the neonatal intensive care unit at London’s Great Ormond Street Hospital, one of the world’s leading children’s hospitals, and treated for encephalomyopathic mitochondrial DNA depletion syndrome, a rare genetic condition which prevents cells from producing sufficient energy to maintain normal bodily functions. Experts on my form of MDDS, called RRM2B, unanimously agreed that there was no cure or treatment. At the time of my death on July 27, 2017, it was thought that only sixteen children globally have this condition.

Aryepiglottoplasty for laryngomalacia: 100 consecutive cases

2001 ◽  
Vol 115 (1) ◽  
pp. 35-38 ◽  
Author(s):  
S. C. Toynton ◽  
M. W. Saunders ◽  
C. M. Bailey
Keyword(s):  
Complication Rate ◽  
Neurological Disease ◽  
Failure To Thrive ◽  
Indications For Surgery ◽  
Airway Compromise ◽  
Feeding Problems ◽  
Street Hospital ◽  
Feeding Difficulties ◽  
Great Ormond Street Hospital ◽  
Feeding Difficulty

A retrospective review of the notes of 100 consecutive patients who had undergone aryepiglottoplasty for laryngomalacia, at Great Ormond Street Hospital for Children, was undertaken. Fifty-six were male, 44 female and 47 were under three months of age. Indications for surgery were oxygen desaturation below 92 per cent and feeding difficulties causing failure to thrive. Forty-seven patients had other pathology contributing to their airway compromise or feeding problems. Improvement in stridor after one month was achieved in 86/91 (94.5 per cent) being abolished completely in 50/91 (55 per cent). Of the 25 per cent of patients whose symptoms took more than one week to resolve, 16/22 (63.6 per cent) were later found to have a serious neurological condition. Feeding was improved in 42 of 58 patients (72.4 per cent) who had a pre-operative feeding difficulty. The complication rate was low, with only five out of 86 (10 per cent) experiencing initial worsening of the airway and six per cent having aspiration of early feeds before improvement occurred.Endoscopic aryepiglottoplasty remains the operation of choice for patients with severe laryngomalacia, however, in the presence of neurological disease surgery is less likely to be successful.

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