Ballooned trachea caused by cuffed tracheostomy tube

Despite the dramatic decrease in cuff-related complications with the introd uction of high-volume low-pressure devices for intubation and tracheostomy, notable problems can still occur. A case is reported of a patient who deve loped persistent dilatation of the trachea after prolonged mechanical venti lation. This is an under-recognized, life threatening clinical entity occur ring after cuffed intubation for prolonged time. At present there is no def initive treatment regarding the management of a dilated trachea on a ventil ator-dependent patient and therefore emphasis is directed at prevention. Th e patient presented was managed with periodical alterations of the cuff lev el which although not achieving any reversal of the dilatation, have preven ted further progression of tracheal damage. During the follow-up period, re gular assessment with flexible endoscopy has provided more reliable informa tion on the condition of the trachea than computed tomography (CT) scanning .