Cleaning and Replacing the Inner Cannula
The primary purpose of the inner cannula is to prevent tube obstruction by allowing regular cleaning or replacement. Many episodes of tube obstruction can be prevented with simple inspection and cleaning or changing of the inner cannula. Many plastic tubes are cleaned with a solution of full- or half-strength hydrogen peroxide and sterile water,21–23 but some sources24 recommend using physiological saline alone. Silicone tubes and metal tubes can be damaged by using hydrogen peroxide. The connection joints in metal tubes can be damaged by hydrogen peroxide and by enzyme cleaners, so these tubes should be cleaned by soaking in warm water with mild dishwashing liquid to soften secretions and then using a tracheal brush. Silicone tends to absorb cleaning products, so physiological saline alone should be used to clean silicone tubes. For these reasons, it is important to check manufacturers’ instructions for cleaning tracheostomy tubes.25