ABSTRACT
Tracheostomy is being performed on children with increasing frequency and is usually performed surgically. The indications have changed over the past 100 years and it is now most commonly performed in patients requiring prolonged mechanical ventilation. Multidisciplinary preoperative assessment is valuable. There are some areas of debate regarding the best surgical technique. Care should be taken to minimize early complications related to poor technique. Postoperative management should take place in the intensive care setting. Sedation is frequently necessary for children until the first tube change, which can be performed early if stomal maturation sutures have been used and the condition of the patient is appropriate. Delayed complications may require the input of a specialist airway surgeon. Clinical nurse specialists play an important role in perioperative care. Each center should have a protocol for decannulation. Ex utero intrapartum treatment may necessitate tracheostomy in a high-pressure setting and requires significant planning. Guidelines have been developed regarding tracheostomy management during the COVID-19 pandemic and should be adhered to. © Springer Nature Switzerland AG 2023. All rights reseverd.