Does Cuff Design Impact Insertion and Removal Force of Tracheostomy Tubes? A Bench Model

Area of Science:

• Medical Devices
• Surgical Procedures
• Intensive Care Medicine

Background:

• Percutaneous dilatational tracheostomy (PDT) is a common ICU procedure.
• Tracheal stenosis may result from unrecognized tracheal ring fracture during PDT.
• The force applied during tracheal cannulation correlates with compression.

Purpose of the Study:

• To compare the insertion and removal forces of two tracheostomy tube designs.
• To evaluate the impact of cuff shape on the force required for tracheostomy tube insertion.

Main Methods:

• A bench model simulating tracheal insertion was used.
• Insertion and removal forces of traditional (barrel-cuff) and flexible (taper-cuff) Shiley tracheostomy tubes were measured.
• Three sizes of each tube type were tested using a universal testing machine.

Main Results:

• Significantly less insertion force was needed for the flexible Shiley tracheostomy tube compared to the traditional type.
• Significantly less removal force was also observed for the flexible tracheostomy tube.

Conclusions:

• The flexible Shiley tracheostomy tube, with its taper-shaped cuff, requires less force for insertion.
• Reduced insertion force may lead to decreased tracheal compression and potential injury during PDT.
• This suggests a potential benefit of the flexible tracheostomy tube in minimizing PDT-related tracheal trauma.