Breathe Easy Pediatrics Presents: Tidal Volume Episode 7 – Tracheobronchitis in Children with Tracheostomy Tubes

Tidal Volume is a podcast from ATS Peds focusing on core concepts of pediatric pulmonology. The goal is to bring in depth focus on these core concepts for residents, fellows, early career pulmonologists or even senior faculty looking for a refresher.In episode 7, Ryan Thomas MD from Michigan State University discusses tracheobronchitis in children with tracheostomy tubes with Dan Craven MD and Moshe Prero MD from Case Western Reserve University/Rainbow Babies and Children’s Hospital and Alexander Gipsman MD from Children’s Hospital  of Philadelphia. We discuss their review article Tracheobronchitis in children with tracheostomy tubes: Overview of a challenging problem and why they decided to write on this topic.  We also discuss the importance of tracheobronchitis in this patient population, the risk factors for infection, the microbiology of the airway,  and the diagnosis and treatment of tracheobronchitis in children with tracheostomy tubes.  Guests:  Daniel Craven, MD, Case Western Reserve UniversityMoshe Prero, MD, Case Western Reserve UniversityAlexander Gipsman, MD, Children's Hospital of Philadelphia Host:  Ryan Thomas, MD,  Michigan State University ReviewersChristina Barreda, MD, University of Wisconsin Elizabeth Fiorino, MD, Hofstra University Production/EditingRyan Thomas, MD,  Michigan State University Contact Information:TidalVolumeATSPeds@gmail.com Twitter Accounts:Ryan Thomas, MD@MSUPedsPulm@ATSPeds References Gipsman A, Prero M, Toltzis P, Craven D. Tracheobronchitis in children with tracheostomy tubes: Overview of a challenging problem. Pediatr Pulmonol. 2022 Apr;57(4):814-821.Akangire G, Manimtim W, Nyp M, et al. Factors leading to rehospitalization for tracheostomized and ventilator-dependent infants through 2 years of age. J Perinatol. 2017;37(7):857-863.Horan TC, Andrus M, Dudeck MA. CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control. 2008;36(5):309-332. Griese M, Felber J, Reiter K, et al. Airway inflammation in children with tracheostomy. Pediatr Pulmonol. 2004;37(4):356-361. Willson DF, Conaway M, Kelly R, Hendley JO. The lack of specificity of tracheal aspirates in the diagnosis of pulmonary infection in intubated children. Pediatr Crit Care Med. 2014;15(4):299-305. Cline JM, Woods CR, Ervin SE, Rubin BK, Kirse DJ. Surveillance tracheal aspirate cultures do not reliably predict bacteria cultured at the time of an acute respiratory infection in children with tracheostomy tubes. Chest. 2012;141(3):625-631. Rusakow LS, Guarín M, Wegner CB, Rice TB, Mischler EH. Suspected respiratory tract infection in the tracheostomized child: the pediatric pulmonologist's approach. Chest. 1998;113(6):1549-1554. Goldstein I, Wallet F, Nicolas-Robin A, Ferrari F, Marquette CH, Rouby JJ. Lung deposition and efficiency of nebulized amikacin during escherichia coli pneumonia in ventilated piglets. Am J Respir Crit Care Med. 2002;166(10):1375-1381. Herrmann G, Yang L, Wu H, et al. Colistin-tobramycin combinations are superior to monotherapy concerning the killing of biofilm Pseudomonas aeruginosa. J Infect Dis. 2010;202(10):1585-1592. Tamma PD, Turnbull AE, Milstone AM, Lehmann CU, Sydnor ER, Cosgrove SE. Ventilator-associated tracheitis in children: does antibiotic duration matter? Clin Infect Dis. 2011;52(11):1324-1331. Chastre J, Wolff M, Fagon JY, et al. Comparison of 8 vs 15 days of antibiotic therapy for ventilator-associated pneumonia in adults: a randomized trial. JAMA. 2003;290(19):2588-2598. Silva RC, Ojano-Dirain CP, Antonelli PJ. Effectiveness of pediatric tracheostomy tube cleaning. Arch Otolaryngol Head Neck Surg. 2012;138(3):251-256. Morrison JM, Hassan A, Kysh L, Dudas RA, Russell CJ. Diagnosis, management, and outcomes of pediatric tracheostomy-associated infections: A scoping review. Pediatr Pulmonol. 2022 May;57(5):1145-1156. Jutras C, Autmizguine J, Chomton M, et al. Inhaled antibiotics for the prevention of respiratory tract infections in children with a tracheostomy. Front Pediatr. 2021;9:633039.