Chapter 10 - Tracheal tubes, tracheostomy tubes

Summary

This chapter concentrates on characteristics of the cuffed tube. With a cuffed tube, it is important that the insertion depth is sufficient to avoid inflating the cuff within the larynx itself. Cuffed tubes are generally used in adult practice to seal the airway to protect it from soiling from above and to prevent gas leaks. Three factors contribute to the extent of cuff induced tracheal damage: cuff characteristics, cuff pressure regulation, and cuff inflation technique and medium. Tracheal tubes are attached to the breathing system via tapered male to female 15 mm International Organization for Standardization (ISO) connectors. Tracheostomy tubes with a 15 mm ISO connector can be connected directly to a breathing circuit. Tube characteristics may influence the risk of ventilator-associated pneumonia (VAP). The chapter also reviews special tubes such as laser tubes, microlaryngoscopy tubes, and tubes for paediatric practice.