{"title":"Características de los pacientes traqueostomizados en seguimiento por un Servicio de Atención Paliativa y de Paciente Crónico Complejo (SAPPCC)","authors":"Gemma Pons-Tomàs , Rodrigo Morales Painamil , Sílvia Ricart Campos , Eduard Pellicer Arasa , Lucía Peñarrubia Sanflorencio , Laura Ponce Corredor , Isabel Torrús López","doi":"10.1016/j.anpedi.2023.12.006","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction and objectives</h3><p>In recent years, there has been an increase in the number of children with tracheostomies. The objective was to describe the characteristics of paediatric patients with a tracheostomy followed up by the palliative care and complex chronic patient service (PCCCPS) of a tertiary care hospital.</p></div><div><h3>Methods</h3><p>Single-centre retrospective observational study in patients aged less than 18<!--> <!-->years with a tracheostomy manage by the PCCCPS of a tertiary care hospital (November 2020-June 2022). We analysed epidemiological, clinical, microbiological and social data by reviewing the health records.</p></div><div><h3>Results</h3><p>The sample included 44 tracheostomized patients. The most frequent underlying disease was acquired upper airway disease (20.5%). The most common indication for tracheostomy was upper airway obstruction (66%). Bacterial isolates were detected in 84% of the tracheal aspirates, among which <em>Pseudomonas aeruginosa</em> was most frequent (56.8%). The most frequently prescribed antibiotic was ciprofloxacin (84%). In addition, 18.1% of the patients received at least one course of intravenous antibiotherapy and 29.5% received more than three systemic antibiotic regimens in the past 20<!--> <!-->months. Fifty-nine percent of the children were schooled: 38.6% attended a regular school, 15.9% a special needs school and 4.5% were home-schooled. We identified social difficulties in 53.7%. Also, 22.7% of the families received financial support to care for a child with severe illness.</p></div><div><h3>Conclusions</h3><p>Because of the complexity of caring for tracheostomized children, integral and coordinated management is essential. Schooling is possible and safe if caregivers are trained.</p></div>","PeriodicalId":7783,"journal":{"name":"Anales de pediatria","volume":null,"pages":null},"PeriodicalIF":1.5000,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1695403323002680/pdfft?md5=4cd6ce0aeb6a06435110ba1e4c766634&pid=1-s2.0-S1695403323002680-main.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Anales de pediatria","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1695403323002680","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PEDIATRICS","Score":null,"Total":0}
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Abstract
Introduction and objectives
In recent years, there has been an increase in the number of children with tracheostomies. The objective was to describe the characteristics of paediatric patients with a tracheostomy followed up by the palliative care and complex chronic patient service (PCCCPS) of a tertiary care hospital.
Methods
Single-centre retrospective observational study in patients aged less than 18 years with a tracheostomy manage by the PCCCPS of a tertiary care hospital (November 2020-June 2022). We analysed epidemiological, clinical, microbiological and social data by reviewing the health records.
Results
The sample included 44 tracheostomized patients. The most frequent underlying disease was acquired upper airway disease (20.5%). The most common indication for tracheostomy was upper airway obstruction (66%). Bacterial isolates were detected in 84% of the tracheal aspirates, among which Pseudomonas aeruginosa was most frequent (56.8%). The most frequently prescribed antibiotic was ciprofloxacin (84%). In addition, 18.1% of the patients received at least one course of intravenous antibiotherapy and 29.5% received more than three systemic antibiotic regimens in the past 20 months. Fifty-nine percent of the children were schooled: 38.6% attended a regular school, 15.9% a special needs school and 4.5% were home-schooled. We identified social difficulties in 53.7%. Also, 22.7% of the families received financial support to care for a child with severe illness.
Conclusions
Because of the complexity of caring for tracheostomized children, integral and coordinated management is essential. Schooling is possible and safe if caregivers are trained.
期刊介绍:
La Asociación Española de Pediatría tiene como uno de sus objetivos principales la difusión de información científica rigurosa y actualizada sobre las distintas áreas de la pediatría. Anales de Pediatría es el Órgano de Expresión Científica de la Asociación y constituye el vehículo a través del cual se comunican los asociados. Publica trabajos originales sobre investigación clínica en pediatría procedentes de España y países latinoamericanos, así como artículos de revisión elaborados por los mejores profesionales de cada especialidad, las comunicaciones del congreso anual y los libros de actas de la Asociación, y guías de actuación elaboradas por las diferentes Sociedades/Secciones Especializadas integradas en la Asociación Española de Pediatría.