소아기관절개술 이후 연하기능의 생리적 변화 및 다양한 기관절개관과 부속품에 대한 고찰
Review of the Various Tubes and Accessories Used for Pediatric Tracheostomy, and Changes in Physiology of Swallowing Associated with the Procedure
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Breathing through a tracheostomy tube bypasses the upper respiratory tract. As a result, there is a decrease in heating, humidifying, and filtering of the inhaled air as it passes through the upper respiratory tract. In addition, the presence of the tracheostomy tube induces various physiological and mechanical changes in the normal swallowing function, which can result in dysphagia. Due to the advances in modern medical technology, the survival rate of premature infants, very low birth weight infants with various comorbidities and deformities, and medically fragile infants are increasing, resulting in an increase in the number of tracheostomies being performed in the pediatric population. Moreover, the indications for tracheostomy in pediatric patients have shifted to craniofacial deformities or neurologic deficits that require a long-term tracheostomy tube. These trends in pediatric tracheostomy tend to increase the number of patients suffering from various degrees of dysphagia. Nevertheless, studies on dysphagia in pediatric patients who have undergone tracheostomy and have a long-term tracheostomy tube are scarce. Therefore, this article aims to review the changes in swallowing physiology after tracheostomy, and the various types of tracheostomy tubes and their accessories used for pediatric patients to overcome the potential complications after tracheostomy.
Abstract
Breathing through a tracheostomy tube bypasses the upper respiratory tract. As a result, there is a decrease in heating, humidifying, and filtering of the inhaled air as it passes through the upper respiratory tract. In addition, the presence of the tracheostomy tube induces various physiological and mechanical changes in the normal swallowing function, which can result in dysphagia. Due to the advances in modern medical technology, the survival rate of premature infants, very low birth weight infants with various comorbidities and deformities, and medically fragile infants are increasing, resulting in an increase in the number of tracheostomies being performed in the pediatric population. Moreover, the indications for tracheostomy in pediatric patients have shifted to craniofacial deformities or neurologic deficits that require a long-term tracheostomy tube. These trends in pediatric tracheostomy tend to increase the number of patients suffering from various degrees of dysphagia. Nevertheless, studies on dysphagia in pediatric patients who have undergone tracheostomy and have a long-term tracheostomy tube are scarce. Therefore, this article aims to review the changes in swallowing physiology after tracheostomy, and the various types of tracheostomy tubes and their accessories used for pediatric patients to overcome the potential complications after tracheostomy.
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