Fig. 12.1
Main Features of tracheostomy tube
Actually, two types of tracheostomy tube are now available: (1) the cuffed tracheostomy tube frequently used for patients ventilation and (2) the uncuffed tracheostomy tube frequently used to keep the stoma.
According to materials used, tracheostomy tube may be divided in
1.
This rigid tracheostomy tube has an inner cannula, and it is especially useful in prolonged and home mechanical ventilation. Furthermore, the adult size of this tracheostomy tube is often used in surgical tracheostomy.
2.
Polyvinyl chloride tracheostomy tube softens at body temperature (thermolabile) (Fig. 12.3).
Fig. 12.3
Polyvinyl chloride tracheostomy tube
Most used cannula that conforms itself to patient anatomy and centring the distal tip in the trachea.
3.
Reinforced tracheostomy tube with metallic spiral (Fig. 12.4).
Fig. 12.4
Reinforced tracheostomy tube with metallic spiral
This tracheostomy tube has an adjustable neck flange to allow bedside adjustments to meet patient needs. Because the locking mechanism on the flange tends to deteriorate over time, this tube is easily deployable. The use of these tubes should be considered a temporary solution.
4.
This tube is made of soft biocompatible silicone intended to be gentle on sensitive tracheal tissue. When a seal is no longer needed, the cuff can be deflated, and it will rest tight to shaft, reducing the risk of trauma to the trachea and allowing airflow around the tube supporting the ability to speak.
According to curvature, tracheostomy tubes may be divided in angle or curved tubes
This feature can be used to improve the fit of the tube in the trachea.
1.
This tracheostomy tube has a horizontal and a vertical part of different length. This cannula may be safely positioned but fits less with the anatomical shape of the trachea.
2.
In this tracheostomy tube, the angle formed by the line passing through the horizontal part of the tube that intersects the line passing through the vertical part of the tracheostomy tube has variable curvatures between 88 and 105°. This tube is the most used during percutaneous tracheostomy because it fits well with the stoma.