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Poorly placed tracheostomy tubes: Effects on flow and resistance
Joshua Moorhouse1, Tahir Ali2, Tobias Moorhouse3
1Anaesthetics Department, Wycombe Hospital, High Wycombe, UK.
Journal of the Intensive Care Society
|October 6, 2017
Summary
Incorrect tracheostomy tube positioning increases airway resistance and circuit pressure. Cuffed tubes provide some protection, highlighting the need for accurate tube placement monitoring.
Area of Science:
- Medical Engineering
- Respiratory Physiology
Background:
- Tracheostomy tubes are crucial for airway management.
- Improper positioning can lead to complications.
Purpose of the Study:
- To quantify the impact of tracheostomy tube malposition on airflow resistance.
- To evaluate the influence of tube type (cuffed vs. uncuffed) on resistance.
Main Methods:
- Utilized a laboratory-based tracheal model.
- Tested cuffed and uncuffed tracheostomy tubes at various insertion depths.
- Measured pressure changes at different flow rates.
Main Results:
- Both over- and under-insertion significantly increased circuit pressure (P < 0.05).
- Cuffed tracheostomy tubes demonstrated a protective effect against increased resistance.
- Incorrect positioning leads to greater flow resistance.
Conclusions:
- Incorrect tracheostomy tube placement demonstrably increases airflow resistance.
- Cuffed tubes may mitigate some of the adverse effects of malpositioning.
- Clinical monitoring of tracheostomy tube position is essential.
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