Persistent tracheal dilatation: onset after brief mechanical ventilation with a "soft-cuff" endotracheal tube

Persistent tracheal dilatation, a sign of severe tracheal damage, has been reported in the past primarily as a complication of prolonged mechanical ventilation through high-pressure, low-compliance cuffs of tracheostomy and endotracheal tubes. A case is presented in which a 26-year-old man developed severe tracheal dilatation with a soft-cuff endotracheal tube beginning four days after intubation, which persisted despite only eight total days of intubation and mechanical ventilation. The pathogenesis and possible prevention of this complication are reviewed.