Prevention of tracheal injuries in prolonged ventilation. Laboratory and clinical observations on the use of self-inflating cuffs on ventilating tubes.

We have previously described the design for a new self-inflating cuff for use on endotracheal and tracheostomy tubes. The pressure characteristics of this new cuff have been reported. The present report presents our experience with this self-inflating cuff in over 200 laboratory observations demonstrating its effectiveness in preventing tracheal damage. Tracheostomy tubes mounted with self-inflating cuffs were kept in the dogs for six weeks without causing tracheal ulceration. Our clinical experience in 52 patients is also described. Endotracheal, nasotracheal, and tracheostomy tubes were used intraoperatively and for long periods of ventilation. No tracheal damage could be shown at postmortem examination in two patients dying of their disease, 10 and 25 days after continuous ventilation.