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Clinical characteristics and gaps in palliative care among tracheostomized children: a retrospective observational study

Year: 2025

Type: article

Abstract: OBJECTIVE: To describe the clinical characteristics of tracheostomized children in Northeastern Brazil and to identify existing gaps in the indication and implementation of palliative care. METHODS: This retrospective descriptive study reviewed medical records of children under 15 years who underwent tracheostomy between 2008 and 2019 at a quaternary referral center. RESULTS: Sixty-five tracheostomized patients with indications for palliative care were analyzed. The main reasons for palliative classification were acute life-threatening conditions (50.7 %) and chronic life-threatening conditions (20 %). The most frequent tracheostomy indications were prolonged invasive mechanical ventilation (46.1 %) and severe upper airway obstruction (23 %). The mortality rate was 30.7 %, higher among infants, severely malnourished children, those with Lansky scores below 40 % before tracheostomy, congenital heart disease, bronchopulmonary dysplasia, and multiple comorbidities. Only 10.8 % received palliative care consultations during hospitalization, all in the end-of-life care phase. CONCLUSIONS: The results highlight a critical gap in the provision of palliative care to tracheostomized children. Early involvement of a multidisciplinary palliative care team is crucial to support clinical decision-making, family-centered care, and ensure quality of life. The proposed framework may facilitate timely referral and airway planning in the Intensive therapy, although further validation and qualitative research in various healthcare settings are needed.

Source: Jornal de Pediatria

DOI: 10.1016/j.jped.2025.101480

Authors: Luziane Lais Sabino Silva Luna, Maria do Carmo Menezes Bezerra Duarte, Sheyla Suelle dos Santos Levy, Luciana Santana Lima

Institution: Instituto de Medicina Integral Professor Fernando Figueira

Language: English

Topic: Tracheal and airway disorders

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,800