What type of artificial airway should be recommended for a 10-year-old girl with a C-3 fracture requiring mechanical ventilation after 9 days of intubation?

The recommendation for a tracheostomy tube for a 10-year-old girl with a C-3 fracture who requires long-term mechanical ventilation after an extended period of intubation is grounded in clinical practice. A tracheostomy is often considered when prolonged intubation is necessary, as it provides several advantages over an endotracheal tube, especially for patients who will need support beyond a short duration.

One of the primary benefits of a tracheostomy is the improved airway management and comfort it offers over long periods. Endotracheal tubes, especially when left in place for more than a week, can lead to complications such as airway injury, laryngeal edema, and the risk of ventilator-associated pneumonia. A tracheostomy not only mitigates these risks but also allows for greater oral hygiene and facilitates communication, both of which are especially important in pediatric patients.

In addition, a tracheostomy tube can be more easily managed at home for patients who require ongoing respiratory support, offering a pathway to improved quality of life. The procedure also allows for easier weaning from mechanical ventilation as patients may be more comfortably transitioned to spontaneous breathing trials.

The decision to recommend a tracheostomy in this context is rooted