Ann Rehabil Med.  2020 Oct;44(5):402-408. 10.5535/arm.19210.

What is the Adequate Cuff Volume for Tracheostomy Tube? A Pilot Cadaver Study

• Kim DM
• Shin MJ
• Kim SD
• Shin YB
• Park HE
• Kim YM
• Yoon JA

• KMID: 2508466
• DOI: http://doi.org/10.5535/arm.19210

Abstract

Objective
To determine the patterns of tracheostomy cuff pressure changes with various air inflation amounts in different types of tracheostomy tubes to obtain basic data for appropriately managing longterm tracheostomy.
Methods
We performed tracheostomy on a 46-year-old male cadaver. Three types of tracheostomy tubes (single-cuffed, double-cuffed, and adjustable flange), divided into 8 different subtypes based on internal tube diameters and cuff diameters, were inserted into the cadaver. Air was inflated into the cuff, and starting with 1 mL air, the cuff pressure was subsequently measured using a manometer.
Results
For the 7.5 mm/14 mm tracheostomy tube, cuff inflation with 3 mL of air yielded a cuff pressure within the recommended range of 20–30 cmH₂O. The 7.5 mm/24 mm tracheostomy tube showed adequate cuff pressure at 5 mL of air inflation. Similar values were observed for the 8.0 mm/16 mm and 8.0 mm/27 mm tubes. Double-cuffed tracheostomy cuff pressures (7.5 mm/20 mm and 8.0 mm/20 mm tubes) at 3 mL air inflation had cuff pressures of 18–20 cmH₂O at both the proximal and distal sites. For the adjustable flange tracheostomy tube, cuff pressure at 6 mL of cuff air inflation was within the recommended range. Maximal cuff pressure was achieved at inflation with almost 14 mL of air, unlike other tube types.
Conclusion
Various types of tracheostomy tubes showed different cuff pressures after inflation. These values might aid in developing guidelines For patients who undergo tracheostomy and are discharged home without cuff pressure manometers, this standard might be helpful to develop guidelines.

Keyword

Tracheostomy; Pressure; Tracheomalacia; Respiratory care

Figure

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  Fig. 1. Equivalent air inflation (5 mL) for ideal cuff pressure (20–30 cmH2O) in the cadaver and 2 patients with 7.5 mm/24 mm tube insertion (Portex 100/518/075).

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  Fig. 2. Lower cuff pressure with equal air inflation in an adjustable tracheostomy tube (100/523/070) compared to a single-cuffed tracheostomy tube (Portex 100/518/075).

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