Resumo Strauss e Corbin (1990) Strauss e Corbin (1998) Glaser e Strauss (1967) 1990 (1990 1998 (1998 1967 (1967 199 (199 196 (196 19 (19 1 (1 (

Abstract The Grounded Theory was developed in the 1960s by sociologists Barney Glaser and Anselm Strauss as methodological or research style. New investigative paths have emerged from Grounded Theory application. The aim of the present study is to highlight the antagonism between Glaser and Strauss from a conceptual complementary perspective that opened room for a highly structured and inherently flexible methodology based on the integrative approach. The goal of the Grounded Theory is to develop theories based on systematically collected and analyzed empirical data. The classical approach proved to be excessively subjective to meet empirical research demands in management, overtime. Accordingly, several authors advocate for Strauss and Corbin’s (1990) ideas. The current essay-style study focuses on proposing and assessing an integrative approach framework for the Grounded Theory. Emphasis is given to the complementary qualities suggested by these authors, which are treated as non-exclusionary, despite being influenced by both Strauss and Corbin’s (1998) positivist style and Glaser and Strauss’ (1967) interpretive style. Furthermore, this theory adheres to the fundamental principle of the classical approach, although it emerged from the research process. This methodology’s application can be a promising option for scientific development, since it can disclose potentialities that give researchers flexibility and freedom to create. Thus, ontological and methodological assumptions are choices made by researchers, themselves, since they can gather research methods (mixed-methodology) and follow the combined and sequential use of quantitative and qualitative techniques to create well-founded theories. s data management overtime Accordingly Corbins Corbin 1990 (1990 ideas essaystyle essay nonexclusionary, nonexclusionary non exclusionary, exclusionary non-exclusionary 1998 (1998 1967 (1967 Furthermore process methodologys development Thus themselves mixedmethodology mixed (mixed-methodology wellfounded well founded 199 (199 196 (196 19 (19 1 (1 (

Abstract: Introduction: Pediatric tracheostomy indications have changed over the last 30 years, from acute and transient pro cedures secondary to airway obstruction to programmed tracheostomies indicated due to the need for chronic use of mechanical ventilation (MV). Objective: To describe indications and morbidity associated with pediatric tracheostomies during a ten-year period. Patients and Methods; Descrip tive study. Clinical records review of discharged patients (< 15 years old) tracheostomized during their hospital stay between 2005 and 2015. Demographic and clinical variables were evaluated before and after tracheostomy, stay in intensive care unit, age at the time of the tracheostomy, indication of tracheostomy, early complications (< 7 days), late complications (> 7 days), and mortality. Results; 59 children with tracheostomy were analyzed, 36 (59%) tracheostomies were performed in children under 6 months, and 39 (60%) in males. 23 (39%) had a confirmed or under study genopathy and 25 (42%) had congenital heart disease. The main indications for tracheostomy were 58% secondary to airway disease and 42% due to chronic use of MV. Within the airway disease group, subglottic steno sis, vocal cord paralysis, and tracheobronchomalacia were the principal reasons for indication, and in the group of chronic use of MV, the main causes were bronchopulmonary dysplasia and chronic lung disease. We did not find tracheostomy-related mortality. 89% of the patients were discharged with tracheostomy and 59% with chronic use of MV. The probability of being discharged with a tracheos tomy was higher in younger patients while the chronic use of MV at discharge was higher in patients with a greater number of extubation failures before tracheostomy. Conclusion; Tracheostomy is a safe procedure in children, where the predominant causes of indication are airway disease and the need for chronic use of MV. Most children with tracheostomies are discharged with tracheostomy and chronic use of MV. Younger children, those with difficult weaning, confirmed or suspected ge- nopathy, or special health needs are at greater risk of needing tracheostomy and chronic use of MV.

Resumen: Introducción: La indicación de traqueostomía en pediatría ha cambiado en los últimos 30 años, desde indicaciones agudas y transitorias por obstrucción de la vía aérea a indicaciones programadas y de uso crónico por necesidad de ventilación mecánica (VM) crónica. Objetivo: describir la indicación de traqueostomía y morbilidad asociada al procedimiento, en una cohorte de una década. Pacientes y Método: Estudio descriptivo. Revisión de fichas de egresos hospitalarios (2005-2015) en menores de 15 años traqueostomizados durante su estadía, en una unidad de cuidados intensivos de un hospital universitario. Se evaluaron variables demográficas y clínicas pre y post traqueostomía, estadía en unidad de intensivo, edad al momento de traqueostomía, indicación de ésta, complicaciones precoces (< 7 días), compli caciones tardías (> 7 días), y mortalidad. Resultados: Se consignaron 59 pacientes traqueostomizados, 36 (59%) de ellos menores de 6 meses y 60% en varones. El 39% tuvo una genopatía confirmada o en estudio y el 42% una cardiopatía congénita. Las principales indicaciones fueron compromiso de vía aérea (58%) y VM crónica (42%). En el subgrupo de vía aérea, las principales causas fueron estenosis subglótica, parálisis cordal y traqueobroncomalacia, mientras que en el subgrupo de VM crónica las principales indicaciones fueron displasia broncopulmonar y daño pulmonar crónico. No encontramos mortalidad asociada a traqueostomía. El 89% fue egresado con traqueostomía y el 59% con VM crónica. Los pacientes de menor edad presentaron mayor probabilidad de alta con traqueostomía y aquellos con mayor número de fallas de extubación previo a traqueostomía, presentaron mayor tasa de egreso con VM. Conclusiones: La traqueostomía es un procedimiento seguro en niños, siendo las causas preponderantes la patología de vía aérea y necesidad de VM crónica. La mayoría de los niños traqueostomizados egresó con traqueostomía y VM crónica. Los niños de menor edad, weaning difícil, genopatía confirmada o sospecha, o con necesidad especiales en salud tienen mayor riesgo de necesitar traqueostomía y VM crónica.