Observation on the use of cuffed tracheqstomy tubes (with particular reference to the james tube)

Abstract

Of the many modifications of the cuffed tracheostomy tube, introduced by Trendelenburg m 1869, the "James Tube" manufactured for Medidal and Industrial Equipment Company has been used frequently in our hospital m association with I P P B and for protection against aspiration The angle and the smooth curve of the tube facilitate adjustment to individual patients) and suction The length of the tube may present problems and we prefer an X-ray control of its position Minor adjustments are made by placing a foam Rubber cushion under the connector Continuous humidificabon is essential to avoid obstruction of the lumen by inspissated mucus patients with rubber tracheostomy tubes require expert supervision and care The pressure in the cuff necessary to prevent an air leak is related to the inspiratory pressure required in IPPB Tracheal dilatation was found to be associated with the use of high inflation presures, and the volume of air used in the cuff as well as the diameter of the cuff seen in a chest X-ray appears to be related to pulmonary complications © 1964 Canadian Anesthesiologists.