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K a p i t e x h e a lt h c a r e - S p e c i a l i S t K n o w l e d g e , S u p p o rt a n d c a r e

Extra carE for intEnsivE carE

Essential for the management of VAP protocol


A new range of tracheostomy tubes with subglottic suction features for long-term intensive care situations

3

Tracoe® twist tracheostomy tubes

Our new range of tracheostomy tubes with subglottic suction lines are designed to deliver maximum performance and provide an important tool in the management of ventilator-associated pneumonia (VAP) which is associated with patients in intensive care situations. The range extends to our Experc percutaneous dilation tracheostomy sets with both Tracoe® twist Plus and Tracoe® vario options available.

Key Benefits of subglottic suction

• Accumulated subglottic secretions can be suctioned off

6

Tracoe® twist Plus

at the lowest point, in other words, right above the cuff. This reduces the risk of bacterially contaminated secretions entering the lower respiratory tract and the risk of developing ventilator associated pneumonia (VAP).

Extra-Long tracheostomy tubes

• The suction line is integrated into the wall of the tube to avoid any pressure marks in the tracheostoma. Via this line, secretions can be suctioned off.

• The adjustable neck flange with rotating wings permits universal adjustment to any neck anatomy (e.g. thick necks, post operative odema, asymmetrical necks).

This brochure highlights the Key ranges of Tracoe Tracheostomy tubes with the Subglottic suction facility.

10

Tracoe® vario flexible tracheostomy tubes

specialist Knowledge, support and care

Please note: These styles of tracheostomy tubes are also available in FULL EXPERC Dilation Sets, for Percutaneous Tracheostomy. For details of these sets please contact the KAPITEX sales office, where full details can be given.


tracoe® twist

Tracoe® twist With subglottic suction line

Unique swivelling neck plate for maximum mobility

Now available with subglottic suction line

Light and flexible for increased comfort

• •

Positive locking action

Thin walls allow maximum air flow

Durable and suitable for long term use

Maximum Mobility

• tracoe twist has a unique swivelling neck plate – anatomically shaped, moving around 2 axes i.e. moving in a horizontal and vertical direction. this allows the patient to turn their neck freely in all directions which helps to reduce pressure problems from movement from the distal end of the tube digging into the tracheal mucosa. the anatomical shaped neck flange ensures a perfect fit onto the neck, again a major comfort feature.

• the tracoe twist tubes are more flexible compared with other styles of plastic tubes – this material is light and flexible and with body temperature becomes even more supple – contributing to outstanding comfort for the patient.

tracoe® twist

unique swivelling neckplate

the most outstanding feature of tracoe twist is the anatomically shaped neck flange that moves around two axes: vertically (a) and horizontally (b). the neck strap can be easily attached while the tube is in situ (c).

• Positive locking of the inner cannula is achieved by the tracoe twist inner cannula in the outer tube housing. the arrow on the 15mm connector indicates correct positioning so confidence is provided that the inner cannula is securely in place – particularly important when using with ventilators.

High acceptance

• tracoe twist tracheostomy tubes are suitable throughout the ‘life’ of the tracheostomy – from initial theatre use – to long term use in the community – as they feature weaning caps, which fit over the outer housing; to speaking valves, which of course allows communication to take place – a vital motivation for all tracheostomised patients.

3


tracoe® twist

Tracoe® twist with subglottic suction line

306

888-306

tracoe twist 306 tracheostomy tube, unfenestrated with low pressure cuff and subglottic suction line

tracoe twist 888-306 tracheostomy tube, fenestrated with low pressure cuff and subglottic suction line

Delivery Comprises:

Delivery Comprises:

• outer cannula with cuff and subglottic suction line • 2 inner cannulas with 15mm connector • 2 connectors for suction devices • Perforated obturator and wide neck strap • in sterile package

Order number Size Length* I.D. of inner O.D. of outer (mm) cannula (mm) cannula (mm)

4

• outer cannula, fenestrated with cuff and subglottic suction line

• inner cannula with 15mm connector • inner cannula, fenestrated with 15mm connector • 2 connectors for suction devices • Perforated obturator and wide neck strap • in sterile package Order number Size Length* I.D. of inner O.D. of outer (mm) cannula (mm) cannula (mm)

tr tra 1051

4

56

4.0

7.2

tr tra 1079

4

56

4.0

7.2

tr tra 1052

5

66

5.0

8.6

tr tra 1080

5

66

5.0

8.6

tr tra 1053

6

72

6.0

9.2

tr tra 1081

6

72

6.0

9.2

tr tra 1054

7

74

7.0

10.4

tr tra 1082

7

74

7.0

10.4

tr tra 1055

8

76

8.0

11.4

tr tra 1083

8

76

8.0

11.4

tr tra 1055a

9

78

9.0

12.5

tr tra 1084

9

78

9.0

12.5

tr tra 1056

10

80

10.0

13.5

tr tra 1085

10

80

10.0

13.8

tracoe® twist


888-306-P

tracoe® twist

Tracoe® twist with subglottic suction line and atraumatic inserter

Product Variant:

tracoe®twist 888-306-P tracheostomy tube, fenestrated with subglottic suction line and atraumatic inserter Delivery Comprises:

• outer cannula with cuff and subglottic suction line • inner cannula with 15mm connector • inner cannula, fenestrated with 15mm connector • 2 connectors for suction devices • atraumatic inserter • reinsertion tube • sterile lubricating gel • Perforated obturator and wide neck strap • in sterile package

306-P tracoe®twist 306-P tracheostomy tube, unfenestrated with subglottic suction line and atraumatic inserter Delivery Comprises:

• outer cannula with cuff and subglottic suction line • 2 inner cannulas with 15mm connector • 2 connectors for suction devices • atraumatic inserter • reinsertion tube • sterile lubricating gel • Perforated obturator and wide neck strap • in sterile package

Order number Size Length* I.D. of inner O.D. of outer (mm) cannula (mm) cannula (mm) tr Ext 8067

7

74

7.0

10.4

tr Ext 8068 tr Ext 8069

8 9

76 78

8.0 9.0

11.4 12.5

twist sizing diagram

Order number Size Length* I.D. of inner O.D. of outer (mm) cannula (mm) cannula (mm) tr Ext 0607

7

74

7.0

10.4

tr Ext 0608 tr Ext 0609

8 9

76 78

8.0 9.0

11.4 12.5

Reference numbers and measurements: size

å iD-ic (mm)

ç é í Lengths (mm) ë ê Ba cD oD-oc bc oD-oc bf è (mm) (mm) tL aB (o˚) (mm)

07

7.0

10.4

12.0

74

80.5

95

24

08

8.0

11.4

12.7

76

83.0

90

28

09

9.0

12.5

14.2

78

88.5

90

30

åiD-ic: inside diameter (clear width) at bottom of inner cannula çoD-oc bc: outside diameter éoD-oc bf: outside diameter of outer cannula behind the flange èLength tL: along centre line from start of neck flange to bottom of tube; êLength aB: length along outer bend from start of neck flange to bottom of tube; ëBa: bending angle; ícD: cuff diameter

5


tracoe® twist Plus

Tracoe® twist Plus With subglottic suction line

the tracoe twist Plus range features an additional length of 11-12mm when compared with a standard tube.

the tracoe® twist Plus provides maximum airway flow due to its innovative thinner cannula wall design. this allows the anaesthetist/intensivist to use a larger diameter tracoe twist Plus compared with standard tubes.

Extra long version of the well-proven twist tube

Greatly reduced wall thickness maximises respiratory airflow

Maximum inner lumen - thin walled but stable inner cannula

Increased airflow throughout the key popular sizes!

Now with subglottic suction line

New distal tube end design

New safety locking device for inner tube

equivalent to standard tracoe twist

tracoe twist Plus

7 8 9

8 9 10

Increased airflow (%)

171 160 152

as illustrated, the thinner cannula walls of tracoe twist Plus allow the clinician to go up in tube size, maximising airflow without increasing the outside diameter.* in the example shown opposite this results in an increased airflow of 160%

8 mm

9 mm

08

09

OD = 11.4 mm

OD = 11.8 mm

*airflow measurements can be referred to the Hagen Poiseuille-Law of fluidics

6

tracoe® twist Plus

• Highly improved phonation through

double fenestration (Ref 312 and 314)

d sterile thinner cannula walls to maximise respiratory airflow

• a major benefit of the tracoe twist Plus system is the attention given to maximise the airway/respiratory flow. tracoe twist Plus tubes feature thinner cannula walls – even with the inner cannula in situ.

• this means that the anaesthetist/intensivist can use a larger inside diameter tube – without increasing the outer diameter (see the table opposite).


tracoe twist Plus gives the clinician more choice and flexibility to provide satisfactory outcomes.

tracoe® twist Plus

...dedicated to intensive care use

Improved softer, thinner cuff

• the tracoe twist Plus tubes feature thinner walled cuffs than standard tracheostomy tubes. this type of cuff provides the following benefits:

• reduces the number of folds within the cuff, and narrows the fold formation, providing better sealing and minimising the aspiration channels.

nEW innEr cannULa WitH UniQUE LocKinG sYstEM

• the thinner softer cuff material also provides a less traumatic tube insertion and tube change due to the deflated cuff fitting flatter and tighter to the tube shaft.

extra length

• across all sizes, an additional 11-12mm length will help to stabilise the tube in thicker necks. the extra length will allow the distal end to sit more comfortably in the airway preventing compression against the tracheal wall and so minimising tissue disturbance.

new distal tube end design

• a closer firmer fit of the inner cannula to the outer

tHE nEW cLEar nEcK fLanGE

cannula, due to shaping of the outer cannula, contributes to a reduced risk of surgical emphysema.

• the outer cannula has a more rounded and bevelled shape, thereby providing a smoother finish, allowing an easier entry into the stoma.

easier phonation

• Unique to the tracoe twist Plus fenestrated tube is an extra pair of fenestrations on the underside of the cannula. these extra fenestrations will increase airflow around the tube, making phonation easier and contributing to the weaning process.

new style inner cannula

• to accommodate the extra length the inner cannula

Extra fEnEstrations to iMProvE WEaninG anD PHonation

system now features a unique secure and safe locking system.

• this eliminates the locking of an inner cannula which sometimes occurs when connected to ventilator circuits

• You cannot remove the inner cannula (nor will it slip) unless you turn the locking ring on the inner cannula. twisting the 15mm connector will not release the inner cannula – a major improvement in security which has been requested by many users. this will be a major factor in reducing accidental unlocking of the inner cannula. iMProvED sEaLinG WitH nEW tHinnEr cUff

7


tracoe® twist Plus

Tracoe® twist Plus with subglottic suction line

316

888-316

tracoe® twist Plus 316 tracheostomy tube, unfenestrated, with low pressure cuff and subglottic suction line

tracoe® twist Plus 888-316 tracheostomy tube, double fenestrated, with low pressure cuff and subglottic suction line

Delivery Comprises:

Delivery Comprises:

Order number Size Length* I.D. of inner O.D. of outer (mm) cannula (mm) cannula (mm)

Order number Size Length* I.D. of inner O.D. of outer (mm) cannula (mm) cannula (mm)

• outer cannula with cuff and subglottic suction line • 2 inner cannulas with 15mm connector • 2 connectors for suction devices • Perforated obturator and wide neck strap • in sterile package

• outer cannula with cuff and subglottic suction line • 2 inner cannulas with 15mm connector • 2 connectors for suction devices • Perforated obturator and wide neck strap • in sterile package

tr tra 5167

7

85

7.0

9.8

tr tra 8167

7

85

7.0

9.8

tr tra 5168

8

88

8.0

10.8

tr tra 8168

8

88

8.0

10.8

tr tra 5169

9

90

9.0

11.8

tr tra 8169

9

90

9.0

11.8

tr tra 5170

10

92

10.0

12.8

tr tra 8170

10

92

10.0

12.8

innovative features delivering maximum performance

8

tracoe® twist Plus


888-316-P Product Variant:

tracoe® twist Plus

Tracoe® twist Plus with subglottic suction line and atraumatic inserter

tracoe®twist Plus 888-316-P tracheostomy tube, double fenestrated with subglottic suction line and atraumatic inserter Delivery Comprises:

• outer cannula, double fenestrated with cuff and • • • • • • •

316-P tracoe® twist Plus 316-P tracheostomy tube, unfenestrated with subglottic suction line and atraumatic inserter Delivery Comprises:

• outer cannula with cuff and subglottic suction line • 2 inner cannulas with 15mm connector • 2 connectors for suction devices • atraumatic insertion system • sterile lubricating gel • Perforated obturator and wide neck strap • in sterile package

subglottic suction line inner cannula with 15mm connector inner cannula double fenestrated with 15mm connector 2 connectors for suction devices atraumatic insertion system sterile lubricating gel Perforated obturator and wide neck strap in sterile package

Order number Size Length* I.D. of inner O.D. of outer (mm) cannula (mm) cannula (mm) tr Ext 8167

7

85

7.0

9.8

tr Ext 8168 tr Ext 8169 tr Ext 8170

8 9 10

88 90 92

8.0 9.0 10.0

10.8 11.8 12.8

twist Plus sizing diagram

Order number Size Length* I.D. of inner O.D. of outer (mm) cannula (mm) cannula (mm) tr Ext 1607

7

85

7.0

9.8

tr Ext 1608 tr Ext 1609 tr Ext 1610

8 9 10

88 90 92

8.0 9.0 10.0

10.8 11.8 12.8

Reference numbers and measurements: size

å iD-ic (mm)

ç é í Lengths (mm) ë ê Ba cD oD-oc bc oD-oc bf è (mm) (mm) tL aB (o˚) (mm)

07

7.0

9.8

10.1

85

91

100 26

08

8.0

10.8

11.1

88

95

100 28

09

9.0

11.8

12.1

90

99

100 30

10 10.0

12.8

13.1

92

102

100 32

åiD-ic: inside diameter (clear width) at bottom of inner cannula çoD-oc bc: outside diameter éoD-oc bf: outside diameter of outer cannula behind the flange èLength tL: along centre line from start of neck flange to bottom of tube; êLength aB: length along outer bend from start of neck flange to bottom of tube; ëBa: bending angle; ícD: cuff diameter

9


tracoe® vario

Tracoe® vario With subglottic suction line

Adjustable neck flange allows accurate placement and security

A spring mechanism lets the flange slide easily to a new position and prevents any pressure being exerted on the trachea during adjustment

• •

A scale ensures the exact setting

Neck flange features two pliable wings that can be rotated whether together or independently to provide the most comfortable setting Available in standard and extra long versions with subglottic suction line

numerous adaptabilities (a) a scale ensures the exact positioning of the neck flange in preparation to change tubes (b) as an optional precaution the neck flange can be securely locked by pulling up the orange lever system (c) pliable wings on the flange can be adjusted independently of one another. this helps to meet the unique anatomical requirements of each patient.

locked by pulling up the orange lever system (b). since no screw top is used, no pressure of any kind will be exerted on the trachea.

a Perfect Fit

• the pliable wings on the flange can be adjusted independently of one another (c). this provides additional possibilities for meeting the unique anatomical requirements of each patient.

the unique tracoe vario

• tracoe vario - the flexible tube with the patented variably adjustable neck flange. By means of a practical pressure mechanism, the neck flange can be moved and therefore be adjusted individually to any patient.

• a scale ensures the exact positioning of the neck flange in preparation to change tubes (a). the flange is fixed immediately after its release. additionally as an optional precaution, the neck flange can be securely

10

tracoe® vario

vario sizing diagram


tracoe® vario

Tracoe® vario with subglottic suction line

470 tracoe® vario extract 470 tracheostomy tube with adjustable neck flange,low pressure cuff and subglottic suction line Delivery Comprises:

• cannula with 15mm connector, cuff, x-ray contrast line, • • •

extra-long

471

tracoe® vario extract 471 extra long tracheostomy tube with adjustable neck flange, low pressure cuff and subglottic suction line Delivery Comprises:

• cannula with 15mm connector, cuff, x-ray contrast line,

scale and subglottic suction line 2 connectors for suction pump obturator and wide neck strap in sterile package

scale and subglottic suction line

• 2 connectors for suction pump • obturator and wide neck strap • in sterile package

Order number Size Length* I.D. of inner O.D. of outer (mm) cannula (mm) cannula (mm)

Order number Size Length* I.D. of inner O.D. of outer (mm) cannula (mm) cannula (mm)

tr tra 3029

7

80

7.0

9.7

tr tra 3033

7

104

7.0

9.7

tr tra 3030

8

90

8.0

11.2

tr tra 3034

8

123

8.0

11.2

tr tra 3031

9

100

9.0

12.3

tr tra 3035

9

126

9.0

12.3

tr tra 3032

10

110

10.0

13.7

tr tra 3036

10

135

10.0

13.7

Reference numbers and measurements: 470 size

07

åiD (mm)

7.0

çoD (mm)

9.7

a

33

Lengths (mm) êBa ëcD c B étL èaB (o˚) (mm)

32

15

80

86

100

97

26

Reference numbers and measurements: 471 size

07

åiD (mm)

7.0

çoD (mm)

9.7

a

35

Lengths (mm) êBa ëcD c B étL èaB (o˚) (mm)

36

33

104 110 100

08

8.0

11.2

35

35

20

90

100

28

08

8.0

11.2

37

46

40

123

100

28

09

9.0

12.3

38

35

27

100 106 100

30

09

9.0

12.3

38

46

42

126 134 100

30

10

10.0 13.7

38

37

35

110 120 100

32

10

10.0 13.7

38

52

45

135 146 100

32

åiD: inside diameter (clear width) at bottom of cannula çoD: outside diameter at bottom of cannula étL: length along centre line èaB: length along outer bend êBa: bending angle ëcD: cuff diameter

28

26

åiD: inside diameter (clear width) at bottom of cannula çoD: outside diameter at bottom of cannula étL: length along centre line èaB: length along outer bend êBa: bending angle ëcD: cuff diameter

11


Tracoe® vario

Tracoe® vario with subglottic suction line and atraumatic inserter

470-P Tracoe®vario 470-P tracheostomy tube with subglottic suction line and atraumatic inserter Delivery Comprises:

• x1 Tracoe experc Dilation Set (ref 520) • Ref 470 tube, extra long with 15mm connector with • • • •

cuff, X-ray contrast line, scale, subglottic suction line and atraumatic insertion system 2 connectors for suction devices Sterile lubricating gel Perforated obturator and wide neck strap In sterile package

Reference numbers and measurements: 470-P Order number Size Length* I.D. of inner O.D. of outer (mm) cannula (mm) cannula (mm)

Size

åID (mm)

çOD (mm)

A

Lengths (mm) êBA ëCD C B éTL èAB (O˚) (mm)

TR EXT 4708

8

90

8.0

11.2

08

8.0

11.2

35

35

20

90

100

28

TR EXT 4709

9

100

9.0

12.3

09

9.0

12.3

38

35

27

100 106 100

30

97

Refer to page 10 for sizing diagram

extra-long

471-P

Tracoe®vario 471-P Extra-Long tracheostomy tube with subglottic suction line and atraumatic inserter Delivery Comprises:

• x1 Tracoe experc Dilation Set (ref 520) • Ref 471 tube extra long with 15mm connector with • • • •

cuff, X-ray contrast line, scale, subglottic suction line and atraumatic insertion system 2 connectors for suction devices Sterile lubricating gel Perforated obturator and wide neck strap In sterile package

Reference numbers and measurements: 471-P Order number Size Length* I.D. of inner O.D. of outer (mm) cannula (mm) cannula (mm) TR EXT 4718

8

123

8.0

11.2

TR EXT 4719

9

126

9.0

12.3

Size

åID (mm)

çOD (mm)

A

Lengths (mm) êBA ëCD C B éTL èAB (O˚) (mm)

08

8.0

11.2

37

46

40

123 128 100

28

09

9.0

12.3

38

46

42

126 134 100

30

Refer to page 10 for sizing diagram

Kapitex Healthcare Ltd. Kapitex House, 1 Sandbeck Way, Wetherby, West Yorkshire LS22 7GH, England. Tel: +44 (0) 1937 580211 Fax: +44 (0) 1937 580796 Email: sales@kapitex.com

www.kapitex.com

Due to continuous product developments it may be necessary to alter without notice products within our range. We endeavour to keep all customers informed of product improvements.

© Kapitex Healthcare Ltd. 2012

PBTR0054 REV: 1 10/12

Subglottic Suction  

A new range of tracheostomy tubes with subglottic suction features for long-term intensive care situations.

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