23 doctors weighed in:
Why do pediatric tracheostomies need up-sizing? I know kids of very diff sizes with same trach size.
23 doctors weighed in

Dr. Jonathan Popler
Pediatrics - Pulmonology
15 doctors agree
In brief: Different airways
Different airways can grow differently.
Additionally, there may be other factors involved such as scarring, granulation tissue, granulomas, that need to be taken into account. Airway size does not always depend on age.

In brief: Different airways
Different airways can grow differently.
Additionally, there may be other factors involved such as scarring, granulation tissue, granulomas, that need to be taken into account. Airway size does not always depend on age.
Dr. Jonathan Popler
Dr. Jonathan Popler
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Dr. Varada Divgi
Pediatrics
1 doctor agrees
In brief: Optmum sizing is a
Neonatal and pediatric tracheostomy tubes have a very small inner diameter- can easily get blocked with secretions.
As the child grows the smaller trach tubes can be limiting by creating an airleak around thus affecting an effective ventilation, can be easily dislodged risking a critical airway, affecting a child's growth. Optimum sizing of a tracheostomy tube is an art and a science!

In brief: Optmum sizing is a
Neonatal and pediatric tracheostomy tubes have a very small inner diameter- can easily get blocked with secretions.
As the child grows the smaller trach tubes can be limiting by creating an airleak around thus affecting an effective ventilation, can be easily dislodged risking a critical airway, affecting a child's growth. Optimum sizing of a tracheostomy tube is an art and a science!
Dr. Varada Divgi
Dr. Varada Divgi
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Dr. Craig Uhl
Pediatrics
1 doctor agrees
In brief: As baby grows
So does lung size and the need for more oxygen to fill those lungs and thus a larger conduit to bring more air in with every breath.

In brief: As baby grows
So does lung size and the need for more oxygen to fill those lungs and thus a larger conduit to bring more air in with every breath.
Dr. Craig Uhl
Dr. Craig Uhl
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Dr. James Sidman
ENT - Head & Neck Surgery - Pediatric
1 doctor agrees
In brief: Safety.
Pediatric trach tubes are small, by necessity.
They are easily blocked by secretions and can result in total airway obstruction. So, as a child grows, larger tubes will fit into a larger trachea, and have less chance of total obstruction by secretions.

In brief: Safety.
Pediatric trach tubes are small, by necessity.
They are easily blocked by secretions and can result in total airway obstruction. So, as a child grows, larger tubes will fit into a larger trachea, and have less chance of total obstruction by secretions.
Dr. James Sidman
Dr. James Sidman
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2 comments
Dr. James Sidman
Sorry, I don't understand.
Dr. James Sidman
Neo is same diameter, but shorter. Most 6 yo would use a peds, not neo so they don't come out all the time. These are small tubes (3.5 and 4.0) for this age group. I can't give any more specific advice as I haven't examined your children. Good luck!
Dr. Carla Enriquez
Pediatrics
1 doctor agrees
In brief: Depends
Individuals have different diameter tracheae, different levels of scarring, even if they're similar in size.
So a large child with lots of scarring will need a smaller trach tube than a smaller child with a large tracheal diameter.

In brief: Depends
Individuals have different diameter tracheae, different levels of scarring, even if they're similar in size.
So a large child with lots of scarring will need a smaller trach tube than a smaller child with a large tracheal diameter.
Dr. Carla Enriquez
Dr. Carla Enriquez
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Dr. Robert Fink
Pediatrics
In brief: Breathing Needs
As a child grows they increase their ventilation needs.
A trach tube that is too small will limit ventilation and make it harder for the child to breathe. An adequate size trach tube must allow for ventilation during activity without resistance. If a child had to pull or retract to breathe the trach tube is too small.

In brief: Breathing Needs
As a child grows they increase their ventilation needs.
A trach tube that is too small will limit ventilation and make it harder for the child to breathe. An adequate size trach tube must allow for ventilation during activity without resistance. If a child had to pull or retract to breathe the trach tube is too small.
Dr. Robert Fink
Dr. Robert Fink
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