Acquired tracheoesophageal fistula due to high intracuff pressure

• Main Authors: Hameed Akmal, Mohamed Hasan, Al-Mansoori Motasem
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2008-01-01
• Series: Annals of Thoracic Medicine
• Subjects: Cuff leak; endotracheal tube; intracuff pressure; tracheal damage; tracheoesophageal fistula
• Online Access: http://www.thoracicmedicine.org/article.asp?issn=1817-1737;year=2008;volume=3;issue=1;spage=23;epage=25;aulast=Hameed

High-compliance endotracheal tube cuffs are used to prevent gas leak and also pulmonary aspiration in mechanically ventilated patients. However, the use of the usual cuff inflation volumes may cause tracheal damage and lead to tracheoesophageal fistula. Tracheostomy tube cuffs seal against the tracheal wall and prevent leakage of air around the tube, assuring that the tidal volume is delivered to the lungs. In the past, high-pressure cuffs were used, but these contributed to tracheal injury and have been replaced by high-volume, low-pressure cuffs. For long-term applications, some newer tubes have low-profile (tight to shaft) cuffs that facilitate the tracheostomy tube changes by eliminating the lip that forms when standard cuffs are deflated.