Types of Tracheostomy Tubes

A tracheostomy (trach) tube is a curved tube that is inserted into a tracheostomy stoma (the hole made in the neck and windpipe (Trachea)). There are different types of tracheostomy tubes that vary in certain features for different purposes. These are manufactured by different companies. However, a specific type of tracheostomy tube will be the same no matter which company manufactures them.

A commonly used tracheostomy tube consists of three parts: outer cannula with flange (neck plate), inner cannula, and an obturator. The outer cannula is the outer tube that holds the tracheostomy open. A neck plate extends from the sides of the outer tube and has holes to attach cloth ties or velcro strap around the neck. The inner cannula fits inside the outer cannula. It has a lock to keep it from being coughed out, and it is removed for cleaning. The obturator is used to insert a tracheostomy tube. It fits inside the tube to provide a smooth surface that guides the tracheostomy tube when it is being inserted.

There are different types of tracheostomy tubes available and the patient should be given the tube that best suits his/her needs. The frequency of these tube changes will depend on the type of tube and may possibly alter during the winter or summer months. Practitioners should refer to specialist practitioners and/or the manufacturers for advice.

Tube	Indication	Recommendations
CuffedTube with Disposable Inner Cannula
	Used to obtain a closed circuit for ventilation	Cuff should be inflated when using with ventilators. Cuff should be inflated just enough to allow minimal airleak. Cuff should be deflated if patient uses a speaking valve. Cuff pressure should be checked twice a day. Inner cannula is disposable.
Cuffed Tube with Reusable Inner Cannula
	Used to obtain a closed circuit for ventilation	Cuff should be inflated when using with ventilators. Cuff should be inflated just enough to allow minimal airleak. Cuff should be deflated if patient uses a speaking valve. Cuff pressure should be checked twice a day. Inner cannula is not disposable. You can reuse it after cleaning it thoroughly.
Cuffless Tube with Disposable Inner Cannula
	Used for patients with tracheal problems Used for patients who are ready for decannulation	Save the decannulation plug if the patient is close to getting decannulated. Patient may be able to eat and may be able to talk without a speaking valve. Inner cannula is disposable
Cuffed Tube with Reusable Inner Cannula
	Used for patients with tracheal problems Used for patients who are ready for decannulation	Save the decannulation plug if the patient is close to getting decannulated. Patient may be able to eat and may be able to speak without a speaking valve. Inner cannula is not disposable. You can reuse it after cleaning it thoroughly.
Fenestrated Cuffed Tracheostomy Tube
	Used for patients who are on the ventilator but are not able to tolerate a speaking valve to speak	There is a high risk for granuloma formation at the site of the fenestration (hole). There is a higher risk for aspirating secretions. It may be difficult to ventilate the patient adequately.
Fenestrated Cuffless Tracheostomy Tube
	Used for patients who have difficulty using a speaking valve	There is a high risk for granuloma formation at the site of the fenestration (hole).
Metal Tracheostomy Tube
	Not used as frequently anymore. Many of the patients who received a tracheostomy years ago still choose to continue using the metal tracheostomy tubes.	Patients cannot get a MRI. One needs to notify the security personnel at the airport prior to metal detection screening.