Some inner cannulas are designed to be disposable.
These cannulas usually have a different method of
attachment than nondisposable tubes do, and different
types of disposable cannulas are not interchangeable
(Figure 1). The ease of use of disposable cannulas (simple
removal and replacement) makes them favored by
nurses, but cost may be a factor for patients at home.25,27
Table 3 gives the approximate costs of tracheostomy
supplies. These costs vary widely on the basis of the
materials and cost of production. For patients with a long-term tracheostomy, inquiring about the care the
patients receive at home is a good idea. The information
should include the last time the tube was completely
changed, use of inner cannulas, and suctioning at home.
With certain tubes, such as the DCT (disposable inner
cannula), LPC (low-pressure cuffed), XLT (extended
length) by Shiley (Covidien), or the TRACOE Twist
(TRACOE Medical GmbH), patients cannot receive ventilatory
support via a manual resuscitation bag or a
mechanical ventilator when the inner cannula is not in
place (Figure 2). In these tubes, the 15-mm connector, the
standard connector for all respiratory equipment, is part
of the inner cannula. A temporary inner cannula can be
used while the standard inner cannula is being cleaned