Christopher D. Baker, a pediatric pulmonologist who directs a ventilation care program, and Reshma Amin, a respirologist leading sleep medicine and long-term ventilation, discuss updated tracheostomy guidance. They cover interprofessional, family-centered decision making. They debate GRADE-based recommendations, balancing safety with practicality across resource settings. They also address standardized discharge processes and equity-minded implementation.
30:51
forum Ask episode
web_stories AI Snips
view_agenda Chapters
auto_awesome Transcript
info_circle Episode notes
insights INSIGHT
GRADE Approach Balanced With Safety
The guideline used GRADE methodology to synthesize thousands of papers into evidence-informed recommendations despite many low-certainty areas.
The panel prioritized safety-driven strong recommendations even when randomized trials were infeasible, using expert consensus across disciplines.
insights INSIGHT
Pragmatic International Applicability
The panel intentionally balanced firmness to support resource-limited centers with flexibility to avoid disadvantaging clinicians in varied settings.
This pragmatism aims to make guidelines usable internationally and help smaller centers advocate for resources.
volunteer_activism ADVICE
Standardize Discharge Tailored To Your Center
Develop a standardized discharge process for children with tracheostomies but adapt it to local systems.
Use a center-specific protocol to reduce variability while customizing each patient's plan before discharge.
Get the Snipd Podcast app to discover more snips from this episode
In this Complex Care Journal Club podcast episode, Drs. Reshma Amin and Christopher Baker discuss a clinical practice guideline from the American Thoracic Society on the care of infants and children with tracheostomies. They describe the role of interprofessional and family-centered decision-making, safety- and ethics-driven recommendations, and next steps for implementation across diverse healthcare settings.
SPEAKERS
Reshma Amin, MD, MSc
Staff Respirologist,
Director of Sleep Medicine and Long-term Ventilation
The Hospital for Sick Children
Senior Associate Scientist,
SickKids Research Institute
Professor,
The University of Toronto
Christopher D. Baker, MD
Director, Ventilation Care Program,
Children's Hospital Colorado
Professor of Pediatrics - Pulmonary Medicine
University of Colorado School of Medicine
HOST
Kilby Mann, MD
Associate Professor
Pediatric Rehabilitation Medicine
Children's Hospital Colorado
DATE
Initial publication date: January 13, 2026.
JOURNAL CLUB ARTICLE
Amin R, Agarwal A, Chiang J, Collaco JM, Cristea AI, Propst EJ, Sobotka SA, Balakrishnan K, Benscoter D, Brenner MJ, Castro-Codesal ML, Cuevas Guaman M, Daines CL, Dawson JA, Edwards JD, Graham RJ, Henningfeld JK, Hoekstra NE, Jackson AJ, Johnson RF, Kam K, Kun SS, Napolitano N, Pacheco A, Panitch HB, Prager JD, Shi JY, Soma M, St-Laurent A, Syed F, Watters KF, Zielinski D, Ho ATN, Velagapudi RK, Zeba F, Knight SL, Iyer N, Baker CD. Care of Infants and Children with Tracheostomies: An Official American Thoracic Society Clinical Practice Guideline. Am J Respir Crit Care Med. 2025 Nov;211(11):2001-2020. doi: 10.1164/rccm.202508-2055ST. PMID: 41123183; PMCID: PMC12618984.
OTHER ARTICLES REFERENCED
Sherman JM, Davis S, Albamonte-Petrick S, Chatburn RL, Fitton C, Green C, Johnston J, Lyrene RK, Myer C 3rd, Othersen HB, Wood R, Zach M, Zander J, Zinman R. Care of the child with a chronic tracheostomy. This official statement of the American Thoracic Society was adopted by the ATS Board of Directors, July 1999. Am J Respir Crit Care Med. 2000 Jan;161(1):297-308. doi: 10.1164/ajrccm.161.1.ats1-00. PMID: 10619835.
Sterni LM, Collaco JM, Baker CD, Carroll JL, Sharma GD, Brozek JL, Finder JD, Ackerman VL, Arens R, Boroughs DS, Carter J, Daigle KL, Dougherty J, Gozal D, Kevill K, Kravitz RM, Kriseman T, MacLusky I, Rivera-Spoljaric K, Tori AJ, Ferkol T, Halbower AC; ATS Pediatric Chronic Home Ventilation Workgroup. An Official American Thoracic Society Clinical Practice Guideline: Pediatric Chronic Home Invasive Ventilation. Am J Respir Crit Care Med. 2016 Apr 15;193(8):e16-35. doi: 10.1164/rccm.201602-0276ST. PMID: 27082538; PMCID: PMC5439679.
TRANSCRIPT
https://cdn.bfldr.com/D6LGWP8S/as/wkhzg7pznk5cgb23sk9xg7w7/Amin_and_Baker_Final_transcript_1-9-26_kh_ra_Baker
Clinicians across healthcare professions, advocates, researchers, and patients/families are all encouraged to engage and provide feedback! You can recommend an article for discussion using this form: https://forms.gle/Bdxb86Sw5qq1uFhW6.
Please visit: http://www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children’s Hospital. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open-access. For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu
CITATION
Amin R, Baker CD, Mann K. Balancing Safety, Practicality, and Equity in Pediatric Tracheostomy Guidelines. 1/2026. OPENPediatrics. Online Podcast. https://soundcloud.com/openpediatrics/balancing-safety-practicality-and-equity-in-pediatric-tracheostomy-guidelines.
OPENPediatrics 
