NEW TYPE OF TUBE FOR TRACHEOTOMY WITH INFLATABLE CUFF AND INNER CANNULA.

Abstract

For several years the use of intermittent positive-pressure breathing in the postoperative period has been used on neurosurgical patients at this hospital with increasing frequency. The positive pressure with resultant alveolar inflation has helped prevent postoperative atelectasis and pneumonitis. Intermittent positive-pressure breathing has been particularly useful in patients with quadriplegia who lack intercostal respiratory action and for the first 48 hours after a prolonged neurosurgical procedure. Adequate inflation of the alveoli, however, was impossible utilizing the Chevalier Jackson type of tube for tracheotomy as there was no way to prevent air from escaping from around the tube. Small-cuff type of tubes for endotracheal anesthesia were utilized next, but these had no inner cannula and hence secretions would form on the inside of the tube that were impossible to remove. The tube for tracheotomy that is pictured (Figs. I and ~) has been developedt and used with coinplete success. I t provides not only an inner cannula for cleansing but an inflatable cuff for coinplete occlusion when the intermittent positivepressure breathing is administered (usually for a period of 10 minutes every ~ hours) with a Byrd type of respirator, and an adapter to receive a Byrd type of respirator or fitting for anesthesia. The adapter is a standard size-15 Foregger adapter for anesthesia and is coupled permanently to the cannula for tracheotomy so that there is no