{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T23:46:08Z","timestamp":1787960768516,"version":"build-2784847793"},"reference-count":17,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,6,13]],"date-time":"2025-06-13T00:00:00Z","timestamp":1749772800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>This case series presents four pediatric patients who developed tracheal complications after prolonged invasive mechanical ventilation. The first case involved an 11-year-old girl with severe hypoxic encephalopathy who developed extensive ulcerative granulation tissue obstructing 60% of the tracheal lumen. The second case was that of a 6-year-old boy with ACTA1-related nemaline myopathy who experienced recurrent tracheal obstruction due to granulomatous tissue formation. The third case involved a 9-year-old boy with hydroxyglutaric aciduria and a large plug obstructing his trachea. The last case involved a 19-year-old female with lissencephaly who developed a tracheoesophageal fistula. These cases highlight the importance of regular surveillance and early intervention in managing tracheal complications in pediatric patients with complex chronic conditions requiring long-term mechanical ventilation. The authors emphasize the need for specialized care and routine endoscopic examinations in order to prevent and address potentially life-threatening complications in this vulnerable patient population.<\/jats:p>","DOI":"10.3390\/children12060769","type":"journal-article","created":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T14:03:11Z","timestamp":1750082591000},"page":"769","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Tracheal Complications Following Prolonged Invasive Ventilation in Tracheostomized Pediatric Patients with Complex Chronic Conditions"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-4911-6633","authenticated-orcid":false,"given":"Dejan","family":"Vlajnic","sequence":"first","affiliation":[{"name":"Pediatric Palliative Care Centre, Children\u2019s and Adolescents\u2019 Hospital Datteln, 45711 Datteln, Germany"},{"name":"Department of Children\u2019s Pain Therapy and Pediatric Palliative Care, Faculty of Health, School of Medicine, Witten\/Herdecke University, 58455 Witten, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Wiesmann","sequence":"additional","affiliation":[{"name":"Pediatric Palliative Care Centre, Children\u2019s and Adolescents\u2019 Hospital Datteln, 45711 Datteln, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens","family":"Ortmann","sequence":"additional","affiliation":[{"name":"Pediatric Palliative Care Centre, Children\u2019s and Adolescents\u2019 Hospital Datteln, 45711 Datteln, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mandira","family":"Reuther","sequence":"additional","affiliation":[{"name":"Pediatric Palliative Care Centre, Children\u2019s and Adolescents\u2019 Hospital Datteln, 45711 Datteln, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5875-3775","authenticated-orcid":false,"given":"Boris","family":"Zernikow","sequence":"additional","affiliation":[{"name":"Pediatric Palliative Care Centre, Children\u2019s and Adolescents\u2019 Hospital Datteln, 45711 Datteln, Germany"},{"name":"Department of Children\u2019s Pain Therapy and Pediatric Palliative Care, Faculty of Health, School of Medicine, Witten\/Herdecke University, 58455 Witten, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/j.ijporl.2018.11.021","article-title":"Airway findings in children with tracheostomies: When is diagnostic bronchoscopy and laryngoscopy indicated?","volume":"117","author":"Cheng","year":"2019","journal-title":"Int. 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(Rio J.)"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Merola, R., Vargas, M., Sanfilippo, F., Vergano, M., Mistraletti, G., Vetrugno, L., de Pascale, G., Bignami, E.G., Servillo, G., and Battaglini, D. (2025). Tracheostomy practice in the Italian intensive care units: A point-prevalence survey. Medicina, 61.","DOI":"10.3390\/medicina61010087"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Garc\u00eda Mancebo, J., de La Mata Navazo, S., L\u00f3pez-Herce Arteta, E., Montero Mateo, R., L\u00f3pez Esteban, I.M., Mazzuchelli Dom\u00ednguez, A., S\u00e1nchez Doutel, M., L\u00f3pez-Herce Cid, J., and Gonz\u00e1lez Cort\u00e9s, R. (2021). A comparative two-cohort study of pediatric patients with long term stay in ICUs. Sci. Rep., 11.","DOI":"10.1038\/s41598-021-84248-z"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Merola, R., Iacovazzo, C., Troise, S., Marra, A., Formichella, A., Servillo, G., and Vargas, M. (2024). 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