Annals of Thoracic Medicine Official publication of the Saudi Thoracic Society, affiliated to King Saud University
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Year : 2008  |  Volume : 3  |  Issue : 1  |  Page : 23-25

Acquired tracheoesophageal fistula due to high intracuff pressure

1 Department of ICU, Salmaniya Medical Complex, Manama, Bahrain
2 Department of Anesthesia, Salmaniya Medical Complex, Manama, Bahrain

Correspondence Address:
Akmal A Hameed
Department of ICU, Salmaniya Medical Complex, P.O. Box 12, Manama
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1817-1737.37950

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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 In the past, high-pressure cuffs were used, but these contributed to tracheal injury and have been replaced by high-volume, low-pressure cuffs.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.

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