Does Shiley Tracheostomy Have an Inner Cannula?
Some Shiley tracheostomy tubes have removable inner cannulas while others do not—this is a design feature that varies by specific Shiley model.
Understanding Shiley Tube Variations
Shiley manufactures multiple tracheostomy tube models with different configurations:
- Dual-cannula (with inner cannula): The Shiley Disposable Inner Cannula Tracheostomy Tube (DCT) specifically includes a removable inner cannula 1
- Single-lumen (without inner cannula): Some Shiley models are single-lumen tubes without an inner cannula 2
- Flexible models: The Shiley Flexible Adult tracheostomy tube with TaperGuard cuff is available in both configurations 1
Clinical Significance of Inner Cannulas
Inner cannulas significantly reduce the risk of tube occlusion with secretions when cared for and used appropriately 3. The guidelines emphasize several critical points:
Emergency Management
- If a tracheostomy tube becomes blocked, simply removing the inner tube may resolve the obstruction 3
- In pediatric patients, inner cannulas are most likely only present in older children due to the resulting reduced internal diameter 4
- Some inner cannulas must be replaced after removal to allow connection to standard 15-mm resuscitation and breathing circuits 4, 3, 4
Design Variations
Inner cannulas vary significantly in design 3:
- Single-use disposable tubes with or without fenestrations
- Tubes requiring a dedicated inner cannula for circuit connection
- Tubes that need replacing after cleaning to enable breathing circuit attachment
Impact on Airway Resistance
Removing the inner cannula significantly reduces work of breathing and airway resistance:
- Work of breathing imposed by the tracheostomy tube decreases significantly when the inner cannula is removed across all tube sizes (p < 0.05) 5
- Placing an optional inner cannula increases bidirectional tube resistance by a factor of 3 2
- This may be clinically beneficial when weaning tracheostomized patients from mechanical ventilation 5
Critical Pitfall to Avoid
Unfamiliarity with specific equipment may lead to morbidity and mortality 3. Standardization of tracheostomy tube types within an organization is recommended to reduce errors related to equipment variability 3.
When ordering or managing a Shiley tracheostomy tube, you must verify the specific model designation to determine whether it includes an inner cannula, as this affects emergency management, cleaning protocols, and ventilation strategies.