Hospital records of tracheostomized children from September 2014 to January 2018 were analyzed retrospectively, and information collected with respect to age, gender, parent’s education, indication for tracheostomy, duration, complications, and follow-up.

In the study duration, twelve patients (10 boys) underwent tracheostomy. The median (range) age was 2 years (1 month to 15 years). Four out of 11 (36%) parents had not completed their higher secondary education. Indications of tracheostomy and outcome are presented in Table I. Only tracheobronchomalacia cases required home ventilation and respective duration of home ventilation in each case was 3 months, 4 months and 1 year. The median (range) hospital stay post-tracheostomy was 15.5 (5-55) days and home tracheostomy were 88 (35-850) days. Eight events of non- elective hospitalization were required in four patients; five were infective (pneumonia) and three were due to accidental tube displacement yielding an incidence of 2.14 and 1.28 events per 1000 home tracheostomy days, respectively. All tube displacements occurred in children below one year of age and within two months of home care. No complications were observed during tube change apart from minor bleeding. Nine (82%) children were successfully decannulated, one child was lost to follow-up and one child died at home after 38 days. One child (still on tracheostomy) was awaiting surgical reconstruction for tracheal stenosis by the time of submission of this manuscript. No major problems were encountered post-decannulation.

TABLE I  Demographic and Clinical Characteristics of Patients Discharged With Tracheostomy

This study suggests that home tracheostomy care by parents seems feasible in similar settings. Other studies on pediatric tracheostomy have shown successful decannu-lation rate from 15% to 77% [1-3]. Physicians concerns regarding safety and tracheostomy care of child at home are major hurdles for sending these children home. However, in our experience, the parents managed home tracheostomy well, and there were few complications.

In conclusion, if parents are properly educated and trained in tracheostomy care, it may be feasible and safe to send these children on home tracheostomy care with good outcomes.

Contributors: PKS: conceptualized the study, collected data, written, critically edited and finally approved the manuscript; NV: collected data and finally approved the manuscript.

Funding: None; Competing interest: None stated.

1. Alladi A, Rao S, Das K, Charles AR, D’Cruz AJ. Pediatric tracheostomy: A 13-year experience. Pediatr Surg Int. 2004;20:695-8.

2. Challapudi, G, Natarajan G, Aggarwal S. Single-center experience of outcomes of tracheostomy in children with congenital heart disease. Congenit Heart Dis. 2013;8:556-60.

3. Almeida JC, Esteves SS, Rosa F, Coutinho M, José GS, Sousa AS. Pediatric tracheostomy: The experience from a tertiary center in Portugal. Acta Otorrinolaringol Gallega. 2017;10:144-51.