Anesthesia for the pediatric patient with a tracheostomy

Home ventilation programs support infants and children with chronic respiratory failure either at home or in a long-term care facility. Commonly ventilatory support is via tracheostomy. Occasionally these patients will require anesthesia for emergency surgery. The goal of this article is to provide background on the patient population and techniques for managing the anesthetic. The pre-operative assessment as well as intra- and post-operative management will be addressed. There is specific focus on management of the airway to overcome potential leaks around the tracheostomy tube.