Study Overview: This study aims to understand how changing artificial airways, like tracheostomies or endotracheal tubes, affects the tiny organisms (bacteria) living in these airways of critically-ill children. These devices help kids breathe when they have trouble, but they can also lead to infections. Researchers want to see if swapping these devices changes the types and amounts of bacteria, which could help in treating infections better.

Artificial Airways: Devices like tracheostomies and endotracheal tubes are used to help patients breathe. They are often exchanged to prevent bacterial buildup.

Microbiome: The community of microbes (tiny living things like bacteria) living on or in a particular environment, such as an artificial airway.

• Participation: Involves collecting samples before and after airway exchange; no extra risk as this is routine care.
• Location: Study conducted at Cohen Children's Medical Center.
• Eligibility: All kids in the NICU or PICU with tracheostomies or endotracheal tubes.