As mentioned earlier, tracheomalacia can occur with
sustained overinflation of a cuffed tracheostomy tube
and can be definitively diagnosed by using broncho scopy.
Tracheomalacia is the breakdown of the natural rigid
structure of the trachea that leads to a flaccid airway in
the affected area.31,38,50 Tracheomalacia is common in the
ICU and can occur in tracheostomy patients beginning 1
week after the tracheotomy procedure. It is manifested
by the presence of a cuff leak (air escaping around the
cuff ) combined with overinflation of the cuff and high
cuff pressures. Another contributing factor is traction
from the weight of the ventilator circuit, including inline
devices
such as suction
systems,
heat-moisture
exchangers,
and filters. Methods to prevent tracheomalacia are
directed toward the cause: keep the tracheostomy tube
in neutral position, limit traction against the tube, and
avoid overinflation of the cuff. Short-term treatment for
tracheomalacia is placement of a longer tracheostomy
tube to bypass the affected area.
As mentioned earlier, tracheomalacia can occur withsustained overinflation of a cuffed tracheostomy tubeand can be definitively diagnosed by using broncho scopy.Tracheomalacia is the breakdown of the natural rigidstructure of the trachea that leads to a flaccid airway inthe affected area.31,38,50 Tracheomalacia is common in theICU and can occur in tracheostomy patients beginning 1week after the tracheotomy procedure. It is manifestedby the presence of a cuff leak (air escaping around thecuff ) combined with overinflation of the cuff and highcuff pressures. Another contributing factor is tractionfrom the weight of the ventilator circuit, including inlinedevicessuch as suctionsystems,heat-moistureexchangers,and filters. Methods to prevent tracheomalacia aredirected toward the cause: keep the tracheostomy tubein neutral position, limit traction against the tube, andavoid overinflation of the cuff. Short-term treatment fortracheomalacia is placement of a longer tracheostomytube to bypass the affected area.
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