When should a trach tube cuff be kept inflated?

Keeping the cuff of a tracheostomy tube inflated is essential in specific situations to ensure that the airway remains patent and to prevent aspiration. When a patient is eating or on positive pressure ventilation, it is crucial that the cuff is inflated. This is because the inflated cuff provides a seal within the trachea that prevents food, liquids, or secretions from entering the lungs, thereby reducing the risk of aspiration pneumonia.

During positive pressure ventilation, an inflated cuff also helps ensure that the ventilatory support is effective by preventing air from escaping around the cuff, thus maintaining adequate ventilation and oxygenation. In contrast, when a patient is sleeping or exercising, the requirement for cuff inflation may differ based on their condition and specific risks. Therefore, inflating the cuff during eating or mechanical ventilation is the appropriate practice to safeguard against complications.