Presented at the Annual Meeting of the American Academy of Otolaryngology–Head and Neck Surgery, Washington DC, September 2007.
Received 11 September 2007; received in revised form 8 November 2007; accepted 14 November 2007.
Objective
Conventional cuffed tracheotomy tubes do not prevent aspiration of secretions. Aspiration of saliva may be decreased with the use of a subglottic suction port.
Study Design
Prospective.
Methods
Shiley Disposable Cuffed Tracheotomy (DCT) tubes sizes 4, 6, and 8 (Tyco Healthcare, Pleasanton, CA) were compared to Portex Blue Line Ultra Suctionaid (BLUS) tracheotomy tubes sizes 6, 7, and 8 (Fig 1; Smiths Medical, Watford, UK). All tubes were tested in a simulated tracheal model using 10 cc of human saliva with no suction, intermittent suction, and constant suction (15 minutes).
Results
There was a significant decrease in aspirate between the larger Shiley and BLUS tubes with intermittent suction (mean 8.38 mL Shiley 6 vs 1.60 mL BLUS 7; 8.50 mL Shiley 8 vs 2.80 mL BLUS 8). There was a significant decrease in aspirate between all sizes of Shiley and BLUS tubes with continuous suction. For BLUS 7 and 8, there was a significant difference between intermittent suction (mean, 1.60 mL, 2.80 mL, respectively) and continuous suction (mean, 0.20 mL, 0.60 mL respectively). Shiley and BLUS without suction were equivalent.
Conclusion
Subglottic suction tracheotomy tubes reduce the risk of aspiration beyond the cuff in a bench-top model.
aDepartment of Otolaryngology, University of California, Davis, Sacramento, CA
bDepartment of Otolaryngology, Wake Forest University, Winston-Salem, NC.
Corresponding author: Peter C Belafsky, MD, PhD, Center for Voice and Swallowing, Department of Otolaryngology/HNS, 2521 Stockton Boulevard, Suite 7200, Sacramento, CA 95817.
ABSTRACT