Reappraisal of Tracheal Injury From Cuffed Tracheostomy Tubes

Abstract

Cervical tracheostomy with 72 hours of mechanical ventilation was performed in dogs to compare three techniques for reducing the hazard of tracheal injury from cuffed tracheostomy tubes. Hourly cuff deflation and the use of alternating sites of cuff pressure on the tracheal wall failed to prevent mucosal necrosis and cartilage injury. Careful inflation of the balloon cuff to allow an audible leak during inspiration eliminated significant tracheal injury. On the basis of these experiments, clinical techniques for management of cuffed tracheostomy tubes have been changed with satisfactory early results.