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Year : 2016  |  Volume : 6  |  Issue : 3  |  Page : 98-102

Effect of tracheostomy tube on work of breathing: Comparison of pre- and post-decannulation

1 Department of Respiratory Care, Clínica Basilea, Buenos Aires, Argentina
2 Respiratory Care Sevices, Sanatorio Anchorena, CABA, Buenos Aires, Argentina
3 Cabinet Support the Production of Hospital Information, Hospital Nacional Alejandro Posadas, Buenos Aires, Argentina

Correspondence Address:
Dario Villalba
Clínica Basilea, Solís 1025 (C1078AAU), CABA
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2229-5151.190651

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Objective: To describe and compare the work of breathing (WOB) during spontaneous breathing under four conditions: (1) breathing through a tracheostomy tube with an inflated cuff, (2) breathing through the upper airway (UA) with a deflated cuff and occluded tube, (3) breathing through the UA with an occluded cuffless tube, and (4) postdecannulation. Patients and Methods: Patients who tolerated an occluded cuffless tube were included. Ventilatory variables and esophageal pressure were recorded. The pressure-time product (PTP), PTP/min, and PTP/min/tidal volume (PTP/min/VT) were measured. Each condition was measured for 5 min with a 15 min time interval between evaluations. Quantitative data are expressed as mean ± standard deviation. Single-factor analysis of variance was used, and the Games-Howell test was used for post hoc analysis of comparisons between group means (P ≤ 0.05). Results: Eight patients were studied under each of the four conditions described above. Statistically significant differences were found for PTP, PTP/min, and PTP/min/VT. In the post hoc analysis for PTP, significant differences among all conditions were found. For PTP/min, there was no significant difference between Conditions 2 and 4 (P = 0.138), and for PTP/min/VT, there was no significant difference between Conditions 1 and 2 (P = 0.072) or between Conditions 2 and 3 (P = 0.106). A trend toward a higher PTP, PTP/min, and PTP/min/VT was observed when breathing through a cuffless tracheostomy tube. Conclusion: The four conditions differed with respect to WOB. Cuff inflation could result in a reduced WOB because there is less dead space. Cuffless tracheostomy tubes generate increased WOB, perhaps due to the material deformity caused by body temperature.

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