Pediatric tracheostomy tubes come in the same basic components when compared to adult tracheostomy tubes. Pediatric tracheostomy tubes are manufactured in standard neonatal and pediatric sizes. The neonatal tracheostomy tubes are generally for children under 5kg. Neonatal tubes are shorter in length than pediatric tubes. However, the diameters are the same for neonatal and pediatric and range from 2.5mm to 6.5mm.
Pediatric tracheostomy tubes differ from adult tracheostomy tubes in a few ways. Due to the small size of the tracheostomy tube, pediatric tracheostomy tubes are single lumen tubes, so there is no inner cannula. An inner cannula would further reduce the inner diameter of the tracheostomy tube. There are also no fenestrated tracheostomy tubes available for the pediatric population.
Another difference is that most pediatric tracheostomy tubes are cuffless due to the small diameter of their airways. However, cuffed tracheostomy tubes are also available. Cuffed tracheostomy tubes are used if high ventilatory pressures are needed or the patient is not ventilating adequately with a cuffless tube. Inability to manage secretions with a high aspiration risk may also be an indication. (Although the cuff does not prevent aspiration, the cuff and tube can bypass the secretions).
As a child grows, he or she will require a progressively larger tracheostomy tube.