title: Mechanical ventilation of a patient with decreased lung compliance and tracheal dilatation.
abstract: Tracheal injury resulting from tracheal intubation is common. Injuries vary in type and severity, from mucosal sloughing to tracheal stenosis and fistula formation. We report a patient with poor lung compliance and massive tracheal dilatation as a result of prolonged mechanical ventilation with high inflation pressure despite the use of a high-volume, low-pressure cuff. To reduce the tracheal dilatation but maintain adequate ventilation and continuous positive airway pressure, we substituted a longer double-cuff tracheotomy appliance and used an automatic intermittent cuff inflator. The problems related to the design of modern tracheal tube cuffs are discussed.
authors.affiliation: Department of Anesthesiology, University of Florida College of Medicine, Gainesville.
authors.forename: J M
authors.initials: JM
authors.lastname: Jaeger
authors.forename: N C
authors.initials: NC
authors.lastname: Wells
authors.forename: R R
authors.initials: RR
authors.lastname: Kirby
authors.forename: P B
authors.initials: PB
authors.lastname: Blanch
mesh_terms: D000328:Adult; D002585:Cesarean Section; D002644:Chickenpox / Q000503:physiopathology; D004108:Dilatation, Pathologic; D005260:Female; D006801:Humans; D008170:Lung Compliance / Q000502:physiology*; D011024:Pneumonia, Viral / Q000503:physiopathology*; D011184:Postoperative Period; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000503:physiopathology*; D012121:Respiration, Artificial / Q000295:instrumentation / Q000379:methods*; D014132:Trachea