[Clinical consensus statement on the care of the child with a tracheostomy]. / Consenso sobre el cuidado del niño con traqueostomía.

The care of the child with a tracheostomy deserves special attention because of the potential devastating airway compromise and because of the need of competent care by caregivers and professionals. The recommendations on tracheostomy care published are few and approaches are inconsistent among different institutions. This clinical consensus statement aims to improve care for children with tracheostomies. A literature search was conducted, reviewed and revised by this group of experts, who concurred with these statements, based on the best evidence available and taking into account the local context.

El cuidado del niño con traqueostomía merece especial atención por el potencial riesgo para la vida que podría ocasionarse con el compromiso súbito de la vía aérea y por la necesidad de contar con cuidadores y profesionales competentes para su cuidado. Los objetivos principales de este consenso son unificar criterios, promover prácticas seguras, fomentar el uso racional de los recursos y contribuir a optimizar la calidad de vida de los niños con traqueostomías y sus familias. Para poder cumplir con estos propósitos, se realizó una búsqueda exhaustiva de la literatura científica; se seleccionó, sobre la base del análisis crítico, la mejor evidencia disponible; y se formularon, por consenso interdisciplinario, una serie de recomendaciones prácticas y adaptables al contexto local.

[Primary snoring and obstructive apnea of childhood associated symptoms: prevalence, screening and familiar attitude]. / Ronquido primario y síntomas asociados a apneas obstructivas de la infancia: prevalencia, pesquisa y actitud familiar.

INTRODUCTION: Primary snoring is characterized by absence of apneas. Obstructive sleep apnea syndrome (OSAS) is characterized by upper respiratory tract obstruction that alters ventilation and sleep. Permanent night snoring is the most important risk factor. OBJECTIVE: To know the primary snoring prevalence and OSAS associated symptoms in children of Cordoba. To determine if physicians ask parents about this syndrome and if parents are encouraged to ask about it. POPULATION, MATERIAL AND METHODS: Study design was cross-sectional, population was formed by children that assist to health centers of Cordoba, age ranged from 2 to 11 years. A survey was used to detect snoring presence and associated symptoms. Physicians administer the survey to parents and tutors. Snorer was classified in: permanent, usual, and rare snorer. RESULTS: 1541 survey, snoring prevalence of 9.47%. We compare the permanent snoring group (PS) against the others (US+RS). 55 children (37,67%) were permanent snorers. 51% present respiratory pauses. 13% was strongly moved during a pause. In 74,6% cases, snoring did not motivated physician visit and in 78,8% physician had not asked about snoring in the patient screening. CONCLUSION: We found similar prevalence of snorers than bibliography. 51% of snorer's parents observed respiratory pauses during sleep. Daily and nigthy symptoms presence related to snoring was associated with a meaningfully frequency to the permanent snorers group. It is remarkable the poor importance attributed to this syndrome by physicians and family. It is believed that because of this syndrome frequency, simple diagnosis and solution, physicians should ask about it in patient screening.

Ronquido primario y síntomas asociados a apneas obstructivas de la infancia: prevalencia, pesquisa y actitud familiar / Primary snoring and obstructive apnea of childhood associated symptoms: prevalence, screening and familiar attitude

El ronquido primario se caracteriza por ausencia de apneas. El síndrome de apnea/hipopnea obstructiva del sueño (SAHOS) es la obstrucciónde la vía respiratoria superior que altera laventilación y el sueño. El ronquido nocturno permanentees el factor de riesgo más importante.Objetivo. Conocer la prevalencia del ronquido primarioy de las manifestaciones clínicas asociadas alSAHOS. Determinar si se indaga sobre ambos y simotivan la consulta.Población, material y métodos. Estudio transversal;población, niños de 2-11 años que concurrierona centros de salud de Córdoba. Los médicos residentesencuestaron a los cuidadores para detectar lapresencia de ronquido. Clasificamos al roncador en:permanentemente, frecuentemente y raramenteroncador.Resultados. En 1.541 encuestas, se detectaron 146roncadores (prevalencia: 9,47 por ciento). Se compararon losdatos entre el grupo de permanentemente roncadorescon el resto (subgrupo de frecuentemente roncadoresmás raramente roncadores). Cincuenta y cinconiños (37,67 por ciento) fueron permanentemente roncadores,51 por ciento presentó pausas respiratorias, 13 por ciento fuesacudido durante una pausa. El ronquido no motivóla consulta en 74,6 por ciento y 78,8 por ciento de los pediatras nolo habían indagado.Conclusión. Encontramos una prevalencia de ronquidoen nuestra población similar a la publicada.Los padres del 51 or ciento de los roncadores observaronpausas respiratorias. La presencia de síntomas diurnosy nocturnos relacionados se asoció con frecuenciaestadísticamente mayor al grupo de permanentementeroncadores. La importancia otorgada a estesíndrome por médicos y familias es escasa. Creemosque siendo un cuadro frecuente, de diagnósticoy resolución simple, debería indagarse en la consultamédica

Introduction. Primary snoring is characterized by absence of apneas. Obstructive sleep apnea syndrome (OSAS) is characterized by upper respiratory tract obstruction that alters ventilation and sleep. Permanent night snoring is the most important risk factor. Objective. To know the primary snoring prevalence and OSAS associated symptoms in children of Cordoba. To determine if physicians ask parents about this syndrome and if parents are encouraged to ask about it. Population, material and methods. Study design was cross-sectional, population was formed by children that assist to health centers of Cordoba, age ranged from 2 to 11 years. A survey was used to detect snoring presence and associated symptoms. Physicians administer the survey to parents and tutors. Snorer was classified in: permanent, usual, and rare snorer. Results. 1541 survey, snoring prevalence of 9.47%. We compare the permanent snoring group (PS) against the others (US+RS). 55 children (37,67%) were permanent snorers. 51% present respiratory pauses. 13% was strongly moved during a pause. In 74,6% cases, snoring did not motivated physician visit and in 78,8% physician had not asked about snoring in the patient screening. Conclusion. We found similar prevalence of snorers than bibliography. 51% of snorer‘s parents observed respiratory pauses during sleep. Daily and nigthy symptoms presence related to snoring was associated with a meaningfully frequency to the permanent snorers group. It is remarkable the poor importance attributed to this syndrome by physicians and family. It is believed that because of this syndrome frequency, simple diagnosis and solution, physicians should ask about it in patient screening.

Ronquido primario y síntomas asociados a apneas obstructivas de la infancia: prevalencia, pesquisa y actitud familiar / Primary snoring and obstructive apnea of childhood associated symptoms: prevalence, screening and familiar attitude

El ronquido primario se caracteriza por ausencia de apneas. El síndrome de apnea/hipopnea obstructiva del sueño (SAHOS) es la obstrucciónde la vía respiratoria superior que altera laventilación y el sueño. El ronquido nocturno permanentees el factor de riesgo más importante.Objetivo. Conocer la prevalencia del ronquido primarioy de las manifestaciones clínicas asociadas alSAHOS. Determinar si se indaga sobre ambos y simotivan la consulta.Población, material y métodos. Estudio transversal;población, niños de 2-11 años que concurrierona centros de salud de Córdoba. Los médicos residentesencuestaron a los cuidadores para detectar lapresencia de ronquido. Clasificamos al roncador en:permanentemente, frecuentemente y raramenteroncador.Resultados. En 1.541 encuestas, se detectaron 146roncadores (prevalencia: 9,47 por ciento). Se compararon losdatos entre el grupo de permanentemente roncadorescon el resto (subgrupo de frecuentemente roncadoresmás raramente roncadores). Cincuenta y cinconiños (37,67 por ciento) fueron permanentemente roncadores,51 por ciento presentó pausas respiratorias, 13 por ciento fuesacudido durante una pausa. El ronquido no motivóla consulta en 74,6 por ciento y 78,8 por ciento de los pediatras nolo habían indagado.Conclusión. Encontramos una prevalencia de ronquidoen nuestra población similar a la publicada.Los padres del 51 or ciento de los roncadores observaronpausas respiratorias. La presencia de síntomas diurnosy nocturnos relacionados se asoció con frecuenciaestadísticamente mayor al grupo de permanentementeroncadores. La importancia otorgada a estesíndrome por médicos y familias es escasa. Creemosque siendo un cuadro frecuente, de diagnósticoy resolución simple, debería indagarse en la consultamédica (AU)

Introduction. Primary snoring is characterized by absence of apneas. Obstructive sleep apnea syndrome (OSAS) is characterized by upper respiratory tract obstruction that alters ventilation and sleep. Permanent night snoring is the most important risk factor. Objective. To know the primary snoring prevalence and OSAS associated symptoms in children of Cordoba. To determine if physicians ask parents about this syndrome and if parents are encouraged to ask about it. Population, material and methods. Study design was cross-sectional, population was formed by children that assist to health centers of Cordoba, age ranged from 2 to 11 years. A survey was used to detect snoring presence and associated symptoms. Physicians administer the survey to parents and tutors. Snorer was classified in: permanent, usual, and rare snorer. Results. 1541 survey, snoring prevalence of 9.47%. We compare the permanent snoring group (PS) against the others (US+RS). 55 children (37,67%) were permanent snorers. 51% present respiratory pauses. 13% was strongly moved during a pause. In 74,6% cases, snoring did not motivated physician visit and in 78,8% physician had not asked about snoring in the patient screening. Conclusion. We found similar prevalence of snorers than bibliography. 51% of snorerµs parents observed respiratory pauses during sleep. Daily and nigthy symptoms presence related to snoring was associated with a meaningfully frequency to the permanent snorers group. It is remarkable the poor importance attributed to this syndrome by physicians and family. It is believed that because of this syndrome frequency, simple diagnosis and solution, physicians should ask about it in patient screening.(AU)