A case report finds success in managing severe tracheal cuff dilation in a ventilator-dependent patient, implying a novel approach.
A 67-year-old ventilator-dependent patient developed acute respiratory decompensation caused by the herniation of the overdistended tracheostomy tube cuff. The patient also had a markedly high ratio of cuff diameter to trachea diameter, presumably due to tracheomalacia. To overcome the problem of providing an adequate airway while positioning the cuff at a tracheal site that was not damaged, we improvised and developed an apparatus consisting of a regular #10 Shiley tracheostomy tube with a #8 Tartan endotracheal tube passed through it. This improvised device was easy to assemble and allowed us to tide the patient over during the acute phase of his problem . (Respir Care 1985;30:95-97.)
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Khan et al. (1985) studied this question.
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