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Ann Thorac Surg 1977;24:49-53
© 1977 The Society of Thoracic Surgeons

Articles

Enlarging Intratracheal Tube Cuff Diameter: A Quantitative Roentgenographic Study of Its Value in the Early Prediction of Serious Tracheal Damage

Faroque Khan, M.B.*, Narayan C. Reddy, M.D.

From the Division of Pulmonary Medicine, The Queens Hospital Center Affiliation of the Long Island Jewish-Hillside Medical Center, New York, and the School of Medicine, Health Sciences Center, State University of New York at Stony Brook, Stony Brook, NY

Accepted for publication January 7, 1977.

* Address reprint requests to Dr. Khan, Division of Pulmonary Medicine, Queens Hospital Center, 82–68 164th St, Queens, NY 11432

A prospective study to radiographically document impending tracheal damage in patients on continuous mechanical ventilation was done in 135 intubated adult patients over an eighteen month period. The previously unrecognized enlarging cuff/trachea ratio over 150% was seen in 18 patients. Five of 9 patients who died with C/T ratio over 150% were autopsied; all had severe tracheal damage at the cuff site. Four of 5 patients who were decannulated/extubated developed tracheal stenosis at the cuff site, necessitating tracheal resection in 3 patients. Thus a C/T ratio over 150% is a reliable clinical indicator of tracheal damage. Some thoughts as to prevention of this iatrogenic disease are presented.




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