摘要 : Over the last few decades, greater numbers of tracheostomies have been performed in medically complex andfragile children to manage upper airway obstruction, progressive neuromuscular disorders, abnormal ventilatorydrive and to fa... 展开 Over the last few decades, greater numbers of tracheostomies have been performed in medically complex andfragile children to manage upper airway obstruction, progressive neuromuscular disorders, abnormal ventilatorydrive and to facilitate airway clearance. The optimal timing of tracheostomy tube placement and methods todetermine suitable patients for the procedure remain unclear. Caring for children with tracheostomies can have aconsiderable financial and psychosocial impact on a family. Pediatric patients with tracheostomies have a 2-3fold greater morbidity and mortality compared to adult patients. Clinicians should provide as much clarity aspossible for families on the positive and negative aspects of pediatric tracheotomies and long term mechanicalventilation prior to tracheostomy placement. Tracheostomies are often placed as a bridge, whilst time forhealing, growth and other therapies are needed to help overcome the indication for tracheostomy. Suitableinvestigations used to determine the optimal timing of decannulation remain physician and institution depen-dent. 收起