ATS Care of Infants and Children With Tracheostomies Guideline Summary - Guideline Central
Treatment
Document Overview

Care of Infants and Children With Tracheostomies

American Thoracic Society


Publication Date: Oct 22, 2025

Page Last Updated: May 5, 2026

Grading of Recommendations, Assessment, Development, and Evaluation (GRADE)-Based Recommendations

Certainty of Evidence

Evidence Quality Definition
HighHigh confidence that the estimated effect is close to the true effect.
ModerateModerate confidence that the estimated effect is close to the true effect, but with a chance that the true effect is considerably different.
LowLow confidence in the estimated effect. Higher likelihood that the true effect is considerably different from the estimated effect.
Very lowVery low confidence in the estimated effect. High likelihood that the true effect is considerably different from the estimated effect.
 

Implications of Clinical Guideline Recommendations by Stakeholder

StakeholderStrong RecommendationConditional Recommendation
PatientThe majority of patients would want the recommended course of action in this situation, and only a small number would not.Many patients in this situation would prefer the recommendation, but a substantial number may not. This is an opportunity for shared decision-making between the clinician and patient.
ClinicianMost individuals should receive the course of action that is recommended. There is a low chance that additional formal decision aids are needed to help individuals make decisions consistent with their values and preferences, and adherence to this recommendation could be used as a performance indicator or quality criterion.Different choices will be applicable to different patients, and additional factors will need to be considered in addition to the recommendation in order for a patient to make a decision according to their values and preferences. Decision aids may be needed to assist individuals in making their best choice. This is an opportunity for shared decision-making between the clinician and patient.
Policy-makerThe recommendation can be widely adapted as policy and can be used for performance indicators.Policy-making will require substantial additional debate and involvement of many and/or additional stakeholders. The likelihood of regional variance is also higher, and performance indicators would need to take into consideration any additional deliberation that has occurred.

Document Overview

Document Title
Care of Infants and Children With Tracheostomies
Authoring Society

American Thoracic Society

Document Publication Date
Oct 22, 2025
Page Last Reviewed/Updated
May 5, 2026
Document Type
Guideline
Country of Publication
United States
Full Text Freely Available
Yes
Full Text Guideline
doi.org/10.1164/rccm.202508-2055ST
Source Citation

Amin R, Agarwal A, Chiang J, et al. Care of Infants and Children with Tracheostomies. An Official American Thoracic Society Clinical Practice Guideline. Am J Respir Crit Care Med. Published online October 22, 2025. doi:10.1164/rccm.202508-2055ST

Document Scope, Criteria, and Use Cases

Scope
Treatment
Diseases/Conditions (MeSH)

D014139 - Tracheostomy

D000098522 - Tracheostomy Decannulation

D014139 - Tracheostomy

D000098522 - Tracheostomy Decannulation

Keywords
tracheostomy care
Inclusion Criteria
Adolescent, Child, Infant
Health Care Settings
Ambulatory, Childcare Center, Emergency Care, Home Health, Hospice, Hospital, Long Term Care, Medical Transportation, School
Intended Users
Dentist, Dietician/Nutritionist, Epidemiology/Infection Prevention, Nurse, Nurse Practitioner, Physician, Physician Assistant, Respiratory Therapist, Social Worker, Speech-Language Pathologist
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