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Pediatric Tracheostomy Highlights

Healthcare Professionals - ...
June 25, 2025
Author: Megan Quinn, MSN, CPNP-PC, Clinical Educator – Tracheostomy
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Megan Quinn MSN, CPNP-PC
Clinical Educator – Tracheostomy

Pediatric patients with tracheostomies differ significantly from their adult counterparts. Their smaller, fragile airways can result in more complicated tracheostomy placement and more intricate care needs.  The varying indications for pediatric tracheostomy continue to evolve, including more cardiopulmonary diagnoses and chronic medical conditions. Additionally, pediatric patients with tracheostomies often have multiple comorbid conditions, leading to increased complexity of their care. The types of products they need after surgery also differ from the products typically used with adults.

There are a variety of tracheostomy tube options for pediatric patients. Tracoe offers the Tracoe Mini and Tracoe Silcosoft tracheostomy tubes. The Tracoe Mini neonatal and pediatric tubes are specially designed for neonates and infants. These tubes are cuffless and made from soft PVC designed for pediatric and neonatal airways. This MRI safe tube is available in a variety of sizes and half sizes to fit a multitude of airways. A proximal extension is available for the pediatric Mini tube, adding length to the tube to provide comfort and safety.

Tracoe Silcosoft tubes, also designed for pediatric airways, offer both a cuffed and uncuffed option in addition to full and half sizes. This spiral-reinforced silicone tube is soft and flexible, providing optimal comfort. This tube also comes with an optional proximal extension, once again putting comfort and safety at the forefront. Tracoe tracheostomy tubes come in standard sizes for both neonatal and pediatric airways. Another outstanding feature of this tracheostomy tube is the variant length option. The Silcosoft line of tracheostomy tubes comes in multiple length options to help provide more individualized patient care.

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In all patients with tracheostomies, humidification and filtration must be restored to optimize pulmonary function. The Freevent XtraCare Mini is an HME specially designed for pediatric patients. This heat and moisture exchanger (HME) provides heat and humidity to the air that patients breathe through the tracheostomy tube. In addition to providing heat and humidification, the filter in the XtraCare Mini helps to reduce inhalation of airborne particles. The filter also helps to protect against viruses and bacteria with >98% and >99% effective filtration, respectively1,2. The filter works on both inhalation and exhalation, providing protection not only to the patient but to their caregivers as well.

Communicating with a tracheostomy tube can be challenging, but speaking valves offer a valuable solution for restoring voice—especially when tailored to the unique needs of each patient. The Tracoe PhonAssist Speaking Valve is designed for both adult and pediatric patients, offering adjustable airflow resistance to support a more personalized and comfortable speaking experience. This level of customization is particularly beneficial for pediatric patients who are learning to use a speaking valve following tracheostomy placement.

To learn more about pediatric tracheostomy, please register for our upcoming webinar “Pediatric Tracheostomy: Key Considerations for the Healthcare Professional” on August 5 at 12p CST.

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References:
1. Nelson Laboratories. Bacterial Filtration Efficiency (BFE) GLP Report. Salt Lake City, USA. Available on request from Atos Medical.
2. Nelson Laboratories. Viral Filtration Efficiency (VFE) GLP Report. Salt Lake City, USA. Available on request from Atos Medical.
3. Fuller C, Wineland AM, Richter GT. Update on Pediatric Tracheostomy: Indications, Technique, Education, and Decannulation. Curr Otorhinolaryngol Rep. 2021;9(2):188-199. https://doi.org/10.1007/s40136-021-00340-y.
4. Gerain O, Adil EA, Kawai K, Watters K, Moritz E, Rahbar R. Indications of pediatric tracheostomy over the last 30 years: Has anything changed?. Int J Pediatr Otorhinolaryngol. 2016;87:144-147. doi:10.1016/j.ijporl.2016.06.018.
5. Harless J, Ramaiah R, Bhananker SM. Pediatric airway management. Int J Crit Illn Inj Sci. 2014;4(1):65-70. doi:10.4103/2229-5151.128015.
6. Hebbar KB, Kasi AS, Vielkind M, et al. Mortality and Outcomes of Pediatric Tracheostomy Dependent Patients. Front Pediatr. 2021;9:661512. Published 2021 May 4. doi:10.3389/fped.2021.661512.
7. Kearney A, Norris K, Bertelsen C, Samad I, Cambridge M, Croft G, et al. Adoption and Utilization of Heat and Moisture Exchangers (HMEs) in the Tracheostomy Patient. Otolaryngol Head Neck Surg. 2023;169(5):1374-1381. https://doi.org/10.1002/ohn.368.
8. Mitchell RB, Hussey HM, Setzen G, Jacobs IN, Nussenbaum B, Dawson C, et al. Clinical Consensus Statement. Otolaryngol Head Neck Surg. 2013;148:6-20. https://doi.org/10.1177/0194599812460376.

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