Abstract
Tracheal injury resulting from tracheal intubation is common. Injuries vary in type and severity, from mucosal sloughing to tracheal stenosis and fistula formation. We report a patient with poor lung compliance and massive tracheal dilatation as a result of prolonged mechanical ventilation with high inflation pressure despite the use of a high-volume, low-pressure cuff. To reduce the tracheal dilatation but maintain adequate ventilation and continuous positive airway pressure, we substituted a longer double-cuff tracheotomy appliance and used an automatic intermittent cuff inflator. The problems related to the design of modern tracheal tube cuffs are discussed.
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