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BRIEF RESEARCH REPORT article

Front. Pediatr.

Sec. Children and Health

Volume 13 - 2025 | doi: 10.3389/fped.2025.1644830

This article is part of the Research TopicInnovative Strategies For Managing Childhood Pain And Pediatric Palliative CareView all articles

Safety and feasibility of tracheostomy and gastrostomy home replacement: a five-year experience from a palliative care center

Provisionally accepted
Francesca  BurloFrancesca Burlo1*Irene  BortolinIrene Bortolin1Domenico  Leonardo GrassoDomenico Leonardo Grasso2Anna  OvegliaAnna Oveglia2Egidio  BarbiEgidio Barbi1,2Lucia  De ZenLucia De Zen2Valentina  TaucarValentina Taucar2Francesca  PeriFrancesca Peri2
  • 1University of Trieste, Trieste, Italy
  • 2IRCCS Materno Infantile Burlo Garofolo, Trieste, Italy

The final, formatted version of the article will be published soon.

Background. Children with medical complexities needing palliative care often rely on tracheostomy and gastrostomy tubes. As home-based care gains priority to improve well-being and reduce hospitalizations, this study evaluates the safety and feasibility of home replacement of these devices. Methods. The study was a cross-sectional observational study of pediatric tracheostomy and/or gastrostomy patients followed at home by the Friuli-Venezia Giulia Regional Pediatric Palliative Care Centre at the Institute for Maternal and Child Health IRCCS 'Burlo Garofolo', Trieste. Data were consecutively collected between March 2020 and October 2024 by reviewing patients' medical records. A general satisfaction survey was additionally sent to caregivers. Results. The study sample included 14 children with a median age of 11 years (range 2–18 years). Among them, 3 (21%) had a tracheostomy, 7 (50%) had a gastrostomy and 4 (29%) had both devices. From 2020 to the present, 77 tracheostomy tube changes and 82 gastrostomy button changes were performed. No complications occurred. Families expressed high satisfaction with home device replacements, with nearly all preferring them over hospital-based changes. Conclusion. This study shows the safety and feasibility of home tracheostomy and gastrostomy replacement, highlighting the strong preference of patients' families for these procedures. By ensuring a secure approach, they help preserve the quality of life for both patients and their families.

Keywords: Palliative Care, Home assistance, Tracheostomy, Gastrostomy, home care, Device replacement

Received: 10 Jun 2025; Accepted: 18 Aug 2025.

Copyright: © 2025 Burlo, Bortolin, Grasso, Oveglia, Barbi, De Zen, Taucar and Peri. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Francesca Burlo, University of Trieste, Trieste, Italy

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