Factors influencing quality of life in children with tracheostomy with emphasis on home care visits: a multi-centre investigation.

OBJECTIVE: Only a few studies have assessed the quality of life in children with tracheostomies. This study aimed to evaluate the quality of life and the factors influencing it in these children. METHOD: This cross-sectional, two-centre study was conducted on paediatric patients living in the community with a tracheostomy by using the Pediatric Quality of Life Inventory. Clinical and demographic information of patients, as well as parents' socioeconomic factors, were obtained. RESULTS: A total of 53 patients met our inclusion criteria, and their parents agreed to participate. The mean age of patients was 6.85 years, and 21 patients were ventilator-dependent. The total paediatric health-related quality of life score was 59.28, and the family impact score was 68.49. In non-ventilator-dependent patients, multivariate analyses indicated that social functioning and health-related quality of life were negatively affected by the duration of tracheostomy. The Quality of Life of ventilator-dependent patients was influenced by care visits and the presence of pulmonary co-morbidities. CONCLUSION: Children with tracheostomies have a lower quality of life than healthy children do. Routine care visits by a respiratory therapist and nurses yielded significantly improved quality of life in ventilator-dependent children.

The effect of iatrogenic trauma on the bone scintigram: an animal study: concise communication.

An animal study was performed to assess the effect on the Tc-99m phosphate bone scintigram of injury by needle aspiration or drill hole to metaphyseal and diaphyseal areas in immature and mature bones. Results showed that in 12 immature rabbits such trauma to metaphyseal regions had no effect on the bone image. Similar metaphyseal trauma in two mature dogs showed definite abnormalities on the bone image, but in one mature rabbit, no abnormality could be identified by scintigram. Diaphyseal trauma always gave a definitely abnormal bone image. Extrapolation of these results to humans should be cautious, but it suggests that needling or drilling in metaphyseal regions in neonates or young children probably does not affect later bone images.

Scintigraphic detection of intrapulmonary bleeding using technetium-99m sulfur colloid: concise communication.

Radionuclide imaging has been successfully used clinically to determine sites of gastrointestinal hemorrhage, but its use in hemoptysis has not been studied. A dog model of intrapulmonary hemorrhage was devised. Utilizing technetium sulfur colloid, at doses of 4 and 15 mCi, bleeding rates of 0.1--0.2 cc/min were detected. In some dogs, however, significantly higher bleeding into a large bronchus, which causes a diffuse distribution of the radionuclide.