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Characteristics
- single or double lumen
- curved or angled
- variable length
- extra proximal length (useful for obese patients)
© Janet Fong, July 2008
Normal length
© Janet Fong, July 2008
Extra proximal length
- extra distal length (useful for patients with tracheal abnormalities)
- fixed or adjustable flange
- ± reinforced (NB not MRI compatible)
- uncuffed or cuffed
- high volume low pressure cuff (most common)
- low volume high pressure
- foam cuffs
- may be useful for patients with tracheomalacia
- sizing
- ISO standard sizes based on the internal diameter of tube
- Jackson sizes - used for Shiley tubes
| Size |
Inner diameter with
inner tube (mm) |
Inner diameter without
inner tube (mm) |
Outer diameter (mm) |
| 4 |
5 |
6.7 |
9.4 |
| 6 |
6.4 |
8.1 |
8.1 |
| 8 |
7.6 |
9.1 |
12.2 |
| 10 |
8.9 |
10.7 |
13.8 |
Single lumen
- cuffed or uncuffed
- cuffed single lumen tubes are suitable for ventilation of patients who
are entirely ventilator-dependent
- variations include
- tubes with the facility for
subglottic aspiration of secretions or vocalization
- foam cuff tubes
- adjustable flange tubes
- may be useful in patients with unusual anatomy of neck,
particularly when the depth of the trachea is such that the fixed
curvature of a standard tracheostomy tube is unsuitable (eg obese
patients)
©Janet Fong, June 2008
Single lumen, cuffed, angled PVC tracheostomy tube
Double lumen
- these have an inner tube which can be removed and cleaned thus reducing
the chance of blockage and facilitating management of tube obstruction
©Janet Fong, June 2008
- note that obstruction at the tip of the tube may not be relieved by
removal of the inner tube
©Janet Fong, June 2008
- generally not suitable for patients who are entirely ventilator
dependent as inner tube may inadvertently slip out
- work of breathing may be increased as the internal diameter is lower
relative to the external diameter than for single lumen tubes
- double lumen tubes may be fenestrated or unfenestrated and cuffed or
uncuffed
- fenestrated tubes have an opening in the tube between the external
orifice and the cuff which allows gas to pass up to and down from the
larynx. Use of an unfenestrated inner tube closes the opening while use
of a fenestrated inner tube opens the passage
©Janet Fong, June 2008
Fenestrated cuffed curved double lumen tube with unfenestrated
inner tube
©Janet Fong, June 2008
Fenestrated cuffed curved double lumen tube with fenestrated
inner tube and external orifice occluded
- generally the fenestrated inner tube is used with the cuff of the
tube deflated and the external orifice of the tube occluded. This allows
the patient to breath through his/her mouth and allows true coughing, as
opposed to huffing
- the unfenestrated inner tube should be used when tracheal suction is
performed to ensure that the suction catheter does not pass out through
the fenestration and impinge on the tracheal wall
Suction catheter passing out of fenestration in inner tube
©Janet Fong, June 2008
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