Dilatation of the trachea treated with the NL-tracheostomy tube.

The NL-tracheostomy tube has a large diameter, large residual volume cuff with automatic and instant cuff pressure regulation. It has been shown in clinical studies to prevent mucosal damage; and depending on airway pressure, it should in theory prevent or delay the onset of trachea dilatation. The authors report 2 patients who developed severe tracheal dilatation with use of standard low volume cuffs during prolonged mechanical ventilation. Placement of the NL-tracheostomy tube with a special long intratracheal leg and cuff positioned below the dilatation abolished the acute problems of air leakage. Tracheal dilatation at the new cuff site did not develop in 1 patient and was slowed in onset in the 2nd patient, who needed high inflation pressures.