Trach size?

carrieanne · #1 02-28-2011, 11:49 AM

I was wondering when (or if) you ever move up a size? Ezra has had a 3.5 (neo then peds) shiley since he was trached at a few weeks old, he is now a year old. I was just wondering because he was given a PMV at 9 months and we slowly work up to him being able to tolerate it for about 30 minutes at a time. He never was able to wear it any longer than that and suddenly would start to cough and gag when he wore it so we stopped using it all together. He had a bronch, scope etc.. recently in preparation for decan and they saw that the trach took up his entire airway. The pulmo commented that he had a "rather small airway" but then said nothing about it later.. I know I tend to over think things but does that seem normal? Not normal? FWIW we switched hospitals and this was the first time any of these doctors had seen him.

JessicaLalonde · #2 02-28-2011, 12:28 PM

If you are working towards a decann then putting in a smaller trach would probably be the next step. It would allow him to pass air more easily past the trach and through his upper airway. It may also help with him wearing the PMV too.

We moved from a 3.5 Peds to a 3.0 when David was 8 months old and it has made a world of difference in the amount of sounds he can make.

Ainsley's Mom · #3 02-28-2011, 04:27 PM

I think generally they don't upsize unless the child is having issues, working too hard to breathe with their current trach size. Upsizing will make PMV use more difficult. Downsizing, though it can help with PMV use means a 3.0 and a 3.0 trach plugs more easily. And having a 2.5 as an emergency back up trach can be a bit worrisome since a 2.5 is practically worthless. My ENT calls them "placecard holders".

Ainsley still wears a 3.5 and she is a large 4 year old.

sofiasmom · #4 02-28-2011, 04:56 PM

Sofia is 2.5 yrs old and is still wearing a NEO size trach. They are significantly shorter than the PED so you may want to ask the docs about going back.

carrieanne · #5 02-28-2011, 10:48 PM

Thanks guys! I wondered why they didn't downsize him but we do have issues with his trach plugging so I'm glad they didn't!

lauryns mum · #6 02-28-2011, 11:06 PM

I was told that the trach size had alot to do with the issues and why they have a trach in the first place. For example, Lauryn's issues are all upper airway, so it doesn't really matter if we move from a neo to a ped...the length doesn't make a difference to it's performance for her. If someone had more lower airway issues or softening of the trachea then it might be more important to have the trach be as close to the corina as possible.