Het kind met een tracheostoma, vroeger en nu; andere indicaties, andere kinderen, andere zorg

- Until a few decades ago, acute infectious airway obstruction was the primary indication for tracheotomy in children. Its incidence has decreased considerably due to vaccination programmes and antibiotic treatment.

- Today, the primary reasons for performing tracheotomy in a child are chronic airway obstruction (laryngeal injury after intubation, craniofacial malformation, lymphangioma) and prolonged artificial ventilation.

- Consequently, the percentage of children who may be decannulated after a short period has decreased.

- Tracheotomised children now require longer and more intensive care than before.

- Hospital discharge is possible if parents and care providers are provided thorough training and counselling; this process requires specific medical, nursing and psychosocial support.

- The increasing proportion of tracheotomised children cared for at home necessitates greater involvement from family practitioners.

Ned Tijdschr Geneeskd. 2007;151:2308-12