Leakage Characteristics of Dual-Cannula Fenestrated Tracheostomy Tubes during Positive Pressure Ventilation: A Bench Study

<div>Transfenestration pressures of Portex Blue Line Ultra (+), TRACOE twist (×), or Rüsch Traceofix (<svg height="8.68571pt" id="M12" style="vertical-align:-0.2063999pt" version="1.1" viewbox="-0.0498162 -8.47931 9.12938 8.68571" width="9.12938pt" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"><g transform="matrix(.013,0,0,-0.013,0,0)"><path d="M674 312C674 491 527 636 346 636S19 491 19 312S165 -11 346 -11S674 133 674 312ZM616 312C616 161 495 39 346 39S77 161 77 312S197 586 346 586S616 463 616 312Z" id="g185-27"></path><glyph.data ascent="989" descent="-303" horiz-adv-x="692" vert-adv-y="692"></glyph.data></g></svg>) tracheostomy tubes plotted against increase in mean airway pressures. Measurements were obtained in volume-controlled ventilation (ventilator rate: 15 breaths·min<sup>−1</sup>, tidal volume: 450 mL) at <svg height="8.69875pt" id="M13" style="vertical-align:-0.3499298pt" version="1.1" viewbox="-0.0498162 -8.34882 32.3604 8.69875" width="32.3604pt" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"><g transform="matrix(.013,0,0,-0.013,0,0)"><path d="M285 378C315 398 338 416 353 432C373 451 384 474 384 503C384 579 325 635 236 635H235C182 635 136 610 108 579L65 516L85 496C110 533 150 575 205 575C258 575 300 543 300 481C300 407 232 369 141 339L147 310C163 315 188 321 211 321C268 321 338 284 338 192C338 94 288 40 217 40C160 40 119 68 93 91C85 98 77 97 69 91C60 84 47 71 46 58C44 46 48 35 62 22C75 10 116 -12 162 -12C234 -12 424 62 424 224C424 297 373 359 285 376V378Z" id="g113-52"></path><glyph.data ascent="3473" descent="-2876" horiz-adv-x="480" vert-adv-y="480"></glyph.data></g><g transform="matrix(.013,0,0,-0.013,6.24,0)"><path d="M447 623H65C61 580 56 530 47 475H76C100 541 106 550 172 550H388C308 376 196 170 91 -1L98 -12L172 -2C268 204 360 408 455 611L447 623Z" id="g113-56"></path><glyph.data ascent="3473" descent="-2876" horiz-adv-x="480" vert-adv-y="480"></glyph.data></g><g transform="matrix(.013,0,0,-0.013,15.388,0)"><path d="M535 290V340H323V533H265V340H52V290H265V84H323V290H535ZM535 -22V28H52V-22H535Z" id="g117-37"></path><glyph.data ascent="3473" descent="-2876" horiz-adv-x="587" vert-adv-y="587"></glyph.data></g><g transform="matrix(.013,0,0,-0.013,25.924,0)"><path d="M384 0V27C293 34 287 42 287 114V635C232 613 172 594 109 583V559L157 557C201 555 205 550 205 499V114C205 42 199 34 109 27V0H384Z" id="g113-50"></path><glyph.data ascent="3473" descent="-2876" horiz-adv-x="480" vert-adv-y="480"></glyph.data></g></svg>°C. Lung simulator compliance: 20 mL·mbar<sup>−1</sup>. TFP: transfenestration pressure; <svg height="11.9316pt" id="M14" style="vertical-align:-3.2957pt" version="1.1" viewbox="-0.0498162 -8.6359 17.6733 11.9316" width="17.6733pt" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"><g transform="matrix(.013,0,0,-0.013,0,0)"><path d="M600 480C600 590 528 650 384 650H143L137 622C222 614 225 607 210 531L130 127C113 41 106 36 23 28L17 0H294L300 28C204 36 195 42 212 127L243 284L314 263C327 263 339 263 352 264C465 271 600 337 600 480ZM508 481C508 351 402 304 329 304C289 304 265 311 250 317L295 559C302 594 310 606 323 611C335 616 350 619 367 619C455 619 508 573 508 481Z" id="g113-81"></path><glyph.data ascent="3473" descent="-2876" horiz-adv-x="617" vert-adv-y="617"></glyph.data></g><g transform="matrix(.0091,0,0,-0.0091,6.656,3.132)"><path d="M442 39L431 68C420 63 406 57 394 57C377 57 359 71 359 118V301C359 353 349 393 314 424C291 443 261 451 230 451C171 438 107 401 79 381C59 366 46 355 46 340C46 316 72 295 91 295C106 295 117 303 122 319C131 350 139 371 152 384C163 397 178 404 197 404C246 404 281 365 281 293V278C260 262 186 232 124 213C69 194 41 161 41 112C41 47 92 -12 163 -12C195 -12 243 25 283 51C288 35 293 22 308 7C319 -4 339 -12 354 -12L442 39ZM281 87C262 68 226 51 199 51C169 51 129 74 129 126C129 162 151 181 190 198C211 208 259 229 281 240V87Z" id="g58-95"></path><glyph.data ascent="1007" descent="-369" horiz-adv-x="449" vert-adv-y="449"></glyph.data></g><g transform="matrix(.0091,0,0,-0.0091,10.568,3.132)"><path d="M708 439H523V409C587 401 594 395 581 344C562 272 534 184 513 118H511C468 225 428 330 391 434H361C318 317 283 217 244 121H242C218 196 193 273 170 349C157 394 160 401 220 409V439H10V409C60 403 67 394 86 343C127 224 165 109 201 -10H233C273 101 314 199 353 299C393 195 432 99 475 -10H507C554 126 596 251 627 334C648 390 657 401 708 409V439Z" id="g58-117"></path><glyph.data ascent="1007" descent="-369" horiz-adv-x="698" vert-adv-y="698"></glyph.data></g></svg>: mean airway pressure.</div>

Anesthesiology Research and Practice

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Figure 4

Figure 4: Leakage Characteristics of Dual-Cannula Fenestrated Tracheostomy Tubes during Positive Pressure Ventilation: A Bench Study 