Proximal suction tracheotomy tube reduces aspiration volume.
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.


METHODS
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.


CONCLUSIONS
Subglottic suction tracheotomy tubes reduce the risk of aspiration beyond the cuff in a bench-top model.
Coffman
Heather M S
HM
Department of Otolaryngology, University of California, Davis, CA, USA.
Rees
Catherine J
CJ
Sievers
Ann E F
AE
Belafsky
Peter C
PC
D004867:Equipment Design; D006801:Humans; D011446:Prospective Studies; D053120:Respiratory Aspiration / Q000209:etiology / Q000517:prevention & control*; D013396:Suction; D014140:Tracheotomy / Q000009:adverse effects* / Q000295:instrumentation*