Tracheostomy tube
Citation, DOI, disclosures and article data
At the time the article was created Amanda Er had no financial relationships to ineligible companies to disclose.
View Amanda Er's current disclosuresAt the time the article was last revised Arlene Campos had no financial relationships to ineligible companies to disclose.
View Arlene Campos's current disclosures- Tracheotomy tube
- Tracheotomy tubes
- Tracheostomy tubes
- Armoured tracheostomy tubes
- Armoured tracheostomy tube
- Armored tracheostomy tubes
- Armored tracheostomy tube
Tracheostomy tubes, a.k.a. tracheotomy tubes, are inserted through a stoma post-tracheostomy to help patients unable to breathe normally. It may be temporary or permanent depending on the patient's condition, with its insertion where clinically indicated showing a lowered in-hospital mortality rate 1. To enable verbal communication, variations of the tube include:
electrolarynx
fenestrated tracheostomy tube
talking tracheostomy tube
speaking valve (e.g. Passy Muir valve)
armoured tracheostomy tube
On this page:
Indications
-
abnormalities in the upper airway
congenital
traumatic
inability to clear mucus from the lungs
laryngeal injury
obstructive sleep apnoea
Contraindications
active cellulitis over anterior neck 2
Radiographic features
Plain radiograph
Unlike endotracheal tubes, there are no universally accepted imaging guidelines on determining the correct tracheostomy tube placement for adult patients. Some suggestions have included the tube tip being located at:
the midpoint between the upper end of the tube (i.e. insertion point) and the carina
the level of the clavicles
NB: Clinical decisions regarding tracheostomy tube size and position should not be based on a chest x-ray 3,4; direct tracheoscopy measurement is still recommended 3.
Complications
Insertion
bleeding
damage to oesophagus
mucus and fluid build-up, leading to breathing difficulties and infection
References
- 1. Combes A, Luyt C, Nieszkowska A, Trouillet J, Gibert C, Chastre J. Is Tracheostomy Associated with Better Outcomes for Patients Requiring Long-Term Mechanical Ventilation?*. Crit Care Med. 2007;35(3):802-7. doi:10.1097/01.ccm.0000256721.60517.b1
- 2. Raimonde AJ, Westhoven N, Winters R. Tracheostomy. [Updated 2021 Dec 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan. NCBI
- 3. Keane A, Saadi R, Slonimsky E, Wilson M, May J. Comparison of Tracheoscopy and Portable Chest X-Ray in the Evaluation of Infant Tracheostomy Tube Position. Int J Pediatr Otorhinolaryngol. 2021;141:110566. doi:10.1016/j.ijporl.2020.110566 - Pubmed
- 4. Tobler W, Mella J, Ng J, Selvam A, Burke P, Agarwal S. Chest X-Ray After Tracheostomy is Not Necessary Unless Clinically Indicated. World J Surg. 2012;36(2):266-9. doi:10.1007/s00268-011-1380-4 - Pubmed
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