Annals of Rehabilitation Medicine

"Tracheomalacia"

Original Article

What is the Adequate Cuff Volume for Tracheostomy Tube? A Pilot Cadaver Study: Dong Min Kim, Myung Jun Shin, Sung Dong Kim, Yong Beom Shin, Ho Eun Park, Young Mo Kim, Jin A Yoon; Ann Rehabil Med 2020;44(5):402-408. Published online September 28, 2020; DOI: https://doi.org/10.5535/arm.19210

Abstract
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Objective
To determine the patterns of tracheostomy cuff pressure changes with various air inflation amounts in different types of tracheostomy tubes to obtain basic data for appropriately managing longterm tracheostomy.
Methods
We performed tracheostomy on a 46-year-old male cadaver. Three types of tracheostomy tubes (single-cuffed, double-cuffed, and adjustable flange), divided into 8 different subtypes based on internal tube diameters and cuff diameters, were inserted into the cadaver. Air was inflated into the cuff, and starting with 1 mL air, the cuff pressure was subsequently measured using a manometer.
Results
For the 7.5 mm/14 mm tracheostomy tube, cuff inflation with 3 mL of air yielded a cuff pressure within the recommended range of 20–30 cmH₂O. The 7.5 mm/24 mm tracheostomy tube showed adequate cuff pressure at 5 mL of air inflation. Similar values were observed for the 8.0 mm/16 mm and 8.0 mm/27 mm tubes. Double-cuffed tracheostomy cuff pressures (7.5 mm/20 mm and 8.0 mm/20 mm tubes) at 3 mL air inflation had cuff pressures of 18–20 cmH₂O at both the proximal and distal sites. For the adjustable flange tracheostomy tube, cuff pressure at 6 mL of cuff air inflation was within the recommended range. Maximal cuff pressure was achieved at inflation with almost 14 mL of air, unlike other tube types.
Conclusion
Various types of tracheostomy tubes showed different cuff pressures after inflation. These values might aid in developing guidelines For patients who undergo tracheostomy and are discharged home without cuff pressure manometers, this standard might be helpful to develop guidelines.

Citations

Citations to this article as recorded by

Tracheotomy
Daniel Gorelik, Yixuan James Zheng, Franklin Wu, Ran A. Wang
Medical Clinics of North America.2026; 110(1): 103. CrossRef
Fluid-Filled Tracheal Tube Cuffs: Implications for Speech, Sealing, and Safety
Thomas C. Blakeman
Respiratory Care.2025; 70(7): 930. CrossRef
Impact of Low‐Volume, Low‐Pressure Tracheostomy Cuffs on Acute Mucosal Injury in Swine
Alexandra J. Berges, Ioan A. Lina, Rafael Ospino, Hsiu‐Wen Tsai, Dacheng Ding, Jessica M. Izzi, Alexander T. Hillel
Otolaryngology–Head and Neck Surgery.2022; 167(4): 716. CrossRef

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Case Report

Successful Management of Acquired Tracheomalacia of Patients With Amyotrophic Lateral Sclerosis: A Report of Three Cases: Jung Hyun Yang, Tae Wan Kim, Byeong Ju Lee, Jin A Yoon, Myung Jun Shin, Yong Beom Shin; Ann Rehabil Med 2018;42(2):368-371. Published online April 30, 2018; DOI: https://doi.org/10.5535/arm.2018.42.2.368

Abstract
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Tracheomalacia is characterized by weakness of the tracheal walls and supporting cartilage. It results in dynamic compression of the airway, where the cross-sectional area of the trachea is reduced by expiratory compression. Acquired tracheomalacia results from complications associated with the use of endotracheal or tracheostomy tubes. In this report, we present three cases of patients with amyotrophic lateral sclerosis (ALS) successfully treated for tracheomalacia, including one case where the patient underwent surgery for combined tracheoesophageal fistula. We discuss the appropriate management strategies for tracheomalacia in patients with ALS. Through these case reports, we note the results of ALS patients who will have tracheostomy, and who are therefore at risk of sustaining a long term high cuff pressure, this study provides an evaluation for tracheomalacia and therapeutic management which should be considered for improving patient care outcomes.

Citations

Citations to this article as recorded by

Acquired Tracheomalacia Following Tracheostomy: A Case Report and Literature Review
Ramli Farid Syamil, Mawaddah Azman
Cureus.2025;[Epub] CrossRef
Factors involved in the one‐year changes in the tracheal diameter of patients with amyotrophic lateral sclerosis undergoing tracheostomy positive pressure ventilation
Nobuhiko Shibasaki, Kaoru Konishi, Tetsuo Miyagawa, Takaya Numayama
Neurology and Clinical Neuroscience.2024; 12(2): 80. CrossRef
A case of amyotrophic lateral sclerosis managed by tracheostomy and invasive ventilation in which air leaks occurred at the cuff
Nobuhiko Shibasaki, Kaoru Konishi, Yutaka Nishiyama, Tetsuo Miyagawa, Takaya Numayama
Rinsho Shinkeigaku.2024; 64(11): 789. CrossRef
Management of tracheostomy‐related tracheomegaly in a patient with COVID‐19 pneumonitis
S. Harper, M. Robinson, G. Manning, A. Jones, J. Hobson, C. L. Shelton
Anaesthesia Reports.2020; 8(2): 159. CrossRef
Death Due to Obstruction of Airways by a Hyperplastic Polyp: An Unusual Complication of Treated Desmoid Fibromatosis
Natasha Richards, Jayantha Herath
Academic Forensic Pathology.2020; 10(2): 97. CrossRef