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To the Editor:—
In response to the excellent letter by Stanley Stellar, MD, in the Feb 22, 1965, issue of The Journal (191:680), I would like to comment on the use of cuffed tracheotomy tubes. We have used these for the past three years with excellent results. The metal ones are preferred, as the nurses can easily clean the inner cannula, positive pressure can be given, and other advantages accrue, as pointed out by the letter writer. However, there are several points of caution which we have learned by bitter experience. First, the rubber cuff must be attached to the metal with a nonslip adhesive (Eastman 910) so that the cuff will not slip over the end of the tracheotomy tube and obstruct the airway, as occurred in one of our patients. Second, the use of acetylcystein (Mucomyst) helps break up tenacious sputum, but also damages the cuffs, so
Benedict JS. Cuffed Tracheotomy Tube to Prevent Aspiration. JAMA. 1965;192(7):647. doi:10.1001/jama.1965.03080200065035