Tracheal infection and stenosis

The tracheal tube may cause infection and stenosis of the airway. These effects may not be considered to be physiological and therefore will only be dealt with briefly.

Secretions can not only occlude the airway lumen but can also be found along the outside of the tube and may pool above the cuff of the tube. They are frequently contaminated by various bacteria and may cause inflammation. Recently, attempts have been made to eliminate these secretions by introducing a catheter outside the tube and down to the cuff for intermittent aspiration. Tubes are also available with a channel in the wall of the tube opening on the outside just above the cuff.

Tracheal stenosis is a frequent complication of intubation with detectable reductions in tracheal area in more than 50 per cent of patients investigated in a number of studies (Holsteta/ 1985). However, only a few develop stenosis that is so severe that it will interfere with physical activities. Still, the occurrence of infections and stenosis point to the need for further refinement of the tracheal tube.

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