Trach Basics: Pediatric Trach Types

by Holly Thompson

Tracheostomy tubes come in a variety of types, sizes, and styles. Most are designed with a neck piece or flange that sits against the throat, and an interior piece, called a cannula, that is passed through the stoma or hole in the neck. They are secured to the neck using trach ties. Most trach tubes these days are made of plastic or silicone, though on rare occasions a metal trach tube may be used.

Bivona Cuffed Trach

Bivona Cuffed Trach


Adult tracheostomy tubes commonly have a double cannula tube, with either a reusable or disposable inner cannula that locks inside a larger outer cannula. Most pediatric patients, on the other hand, use a single cannula tracheostomy tube, cuffed or uncuffed, without the inner cannula.

Cuffed tracheostomy tubes can be chosen for ensuring a tight seal for ventilation support or to prevent aspiration. A small inflation port allows the cuff, which is basically a balloon inside the airway, to be inflated with air, foam, or water as needed. Uncuffed tubes are more frequently used to encourage spontaneous breathing and to improve airflow around the tracheostomy tube for improved vocalization. Infants and very small children may also use uncuffed tubes due to the small size of their airways.

Trach Brands

Shiley and Bivona are the most commonly used brands for children. Both come in a variety of different types to fit the needs of the patient. Shiley and Bivona tracheostomy tubes come in both cuffed and uncuffed styles.

Shiley Uncuffed Trach

Shiley Uncuffed Trach

Shiley tracheostomy tubes also include models with a fenestration hole that improves vocalization. While Bivona has carried some models with a fenestration hole, Shiley carries a larger stock, variety, and size range with this feature.

Bivona carries a wide variety of the conventional hard plastic (PVC) tracheostomy tubes; however Bivona has the corner on the market for flexible silicone tracheostomy tubes with their Pediatric FlexTend Silicone tracheostomy tubes. These feature an extension to the neck of the tube that allows the patient to move more freely without pulling on the stoma. They are generally custom sizes, custom order, and a bit more expensive; however, for active pediatric patients, this type can save lot of wear on the stoma site.


Trach Ties

Tracheostomy tubes are held on by a variety of different ties, but families have been known to choose chains or ribbons to hold a tracheostomy tube in place. These options can be chosen for comfort or style as long as they hold the tracheostomy securely in place and are easily removable for an emergency change.

Author: Holly Thompson • Date: 4/22/2014

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