Tracheostomy Tubes and Related Appliances（气管造口管和相关设备）.pdf

Tracheostomy Tubes and Related Appliances Dean R Hess PhD RRT FAARC Introduction Metal Versus Plastic Tracheostomy Tubes Tracheostomy Tube Dimensions Tracheostomy Tube Cuffs Changing the Tracheostomy Tube Fenestrated Tracheostomy Tubes Dual-Cannula Tracheostomy Tubes Percutaneous Tracheostomy Tubes Subglottic Suction Port Stoma Maintenance Devices Mini-Tracheostomy Tubes Summary Tracheostomy tubes are used to administer positive-pressure ventilation, to provide a patent air- way, to provide protection from aspiration, and to provide access to the lower respiratory tract for airway clearance. They are available in a variety of sizes and styles, from several manufacturers. The dimensions of tracheostomy tubes are given by their inner diameter, outer diameter, length, and curvature. Differences in length between tubes of the same inner diameter, but from different manufacturers, are not commonly appreciated but may have important clinical implications. Tra- cheostomy tubes can be angled or curved, a feature that can be used to improve the fit of the tube in the trachea. Extra proximal length tubes facilitate placement in patients with large necks, and extra distal length tubes facilitate placement in patients with tracheal anomalies. Several tube designs have a spiral wire reinforced flexible design and have an adjustable flange design to allow bedside adjustments to meet extra-length tracheostomy tube needs. Tracheos