This study looks at changes in the airway microbiome of critically-ill children after their artificial airway (like a tube they breathe through) is swapped out. Doctors often use these tubes to help kids breathe when they are very sick. But, the tubes can get germs on them that might lead to infections. By switching these tubes regularly, doctors hope to stop germs from sticking around and causing problems. In this study, doctors will collect samples of mucus (called tracheal aspirates) from the tubes before and after they are changed. Then, they’ll study the bacteria in these samples to see how they change.

• The study takes place at Cohen Children's Medical Center and includes all children with tracheostomies or who have their breathing tubes exchanged.
• No extra risks are involved because tracheal aspirates are collected during routine suctioning.
• This research could help doctors understand better how to prevent infections in children with artificial airways.