ABSTRACT
Tracheostomy in children is now an uncommon operation. Due to a shift in tertiary paediatric treatment to larger centres in the last decade and the lack of a reliable means of collecting data on a national basis, it is difficult to estimate the true incidence of paediatric tracheostomy. Immediately after tracheostomy, the change from air that is warmed and humidified by the upper airway to dry, cold air leads to a rapid increase in airway secretions. This gradually reduces after a few weeks. Secretions dry on the inside of the tracheostomy tube and gradually reduce the effective lumen. Modern tracheostomy tubes are sized in relation to the diameter of the lumen in millimetres and the length of the tube from the skin flange to the tip of the tube. Tracheostomy complications are more likely in children than in adults, and more common in children under 2 years of age,1, particularly preterm infants.
