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However, there remains a paucity of evidence to direct the diagnosis, treatment, and prevention of TRAINs. An important first step to addressing this knowledge gap is to synthesize existing data regarding TRAINs to inform current practice and facilitate innovation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources<\/jats:title>\n                    <jats:p>We searched PubMed, Embase, Cochrane Library, CINAHL, and Web of Science from inception to October 2020. Original research articles and published abstracts including children and young adults 0\u201321\u2009years of age with tracheostomy were included. Included studies assessed the clinical definitions of and risk factors for TRAINs, microbiologic epidemiology and colonization of tracheostomies, and treatment and outcomes of TRAINs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Synthesis<\/jats:title>\n                    <jats:p>\n                      Out of 5755 studies identified in the search, 78 full\u2010text studies were included in the final review. A substantial number of studies focused on the detection of specific pathogens in respiratory cultures including\n                      <jats:italic>Pseudomonas aeruginosa<\/jats:italic>\n                      . Several different definitions of TRAIN including clinical, microbiologic, and laboratory testing results were utilized; however, no uniform set of criteria were identified. The few studies focused on treatment and prevention of TRAIN emphasized the role of empiric antimicrobial therapy and the use of inhaled antibiotics.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Despite a growing number of research articles studying TRAINs, there is a paucity of prospective interventional trials to guide the diagnosis, treatment, and prevention of respiratory disease in this vulnerable population. Future research should include studies of interventions designed to improve short\u2010 and long\u2010term respiratory\u2010related outcomes of children with tracheostomy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.25873","type":"journal-article","created":{"date-parts":[[2022,2,28]],"date-time":"2022-02-28T22:03:25Z","timestamp":1646085805000},"page":"1145-1156","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":44,"title":["Diagnosis, management, and outcomes of pediatric tracheostomy\u2010associated infections: A scoping review"],"prefix":"10.1002","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2882-8849","authenticated-orcid":false,"given":"John M.","family":"Morrison","sequence":"first","affiliation":[{"name":"Department of Pediatrics Johns Hopkins University School of Medicine Baltimore Maryland USA"},{"name":"Division of Pediatric Hospital Medicine Johns Hopkins All Children's Hospital Saint Petersburg Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir","family":"Hassan","sequence":"additional","affiliation":[{"name":"Division of Hospital Medicine Children's Hospital Los Angeles Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynn","family":"Kysh","sequence":"additional","affiliation":[{"name":"The Institute for Nursing and Interprofessional Research Children's Hospital Los Angeles Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert A.","family":"Dudas","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Johns Hopkins University School of Medicine Baltimore Maryland USA"},{"name":"Division of Pediatric Hospital Medicine Johns Hopkins All Children's Hospital Saint Petersburg Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5269-7861","authenticated-orcid":false,"given":"Christopher J.","family":"Russell","sequence":"additional","affiliation":[{"name":"Division of Hospital Medicine Children's Hospital Los Angeles Los Angeles California USA"},{"name":"Department of Pediatrics, Keck School of Medicine University of Southern California Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,3,9]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2009-1658"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2013.432"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24797"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.PCC.0000298641.84257.53"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1542\/hpeds.2017-0106"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2018-2608"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2009.180836"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir531"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12874-018-0611-x"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.3163\/1536-5050.104.3.014"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.7326\/M18-0850"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.02214"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.21206"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/jp.2017.54"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.21536"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-019-03588-x"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.24071"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2019.109800"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1542\/hpeds.2016-0104"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.23938"},{"issue":"60","key":"e_1_2_10_22_1","first-page":"PA1281","article-title":"Management of Pseudomonas aeruginosa infection in children with long\u2010term O2, long\u2010term ventilation or tracheostomy. 7.4 paediatric respiratory infection and immunology","volume":"48","author":"Zhu H","year":"2016","journal-title":"Eur Respirat Soc"},{"key":"e_1_2_10_23_1","unstructured":"National Healthcare Safety Network. 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