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Types of tracheostomy tubes for insertion Tracheostomies can be described by the presence or absence of a cuff at the end, by the presence or absence of an inner cannula, or by the presence or absence of a hole or fenestration. Tubes can be made from different materials and be different diameters and lengths. Choice of tube is influenced by: • The clinical condition • • The type of tracheostomy performed i.e. surgical or percutaneous The expected duration of the tracheostomy cannulation and The individual needs and situation of the patient. Cuffed Tubes The initial tracheostomy tube inserted is commonly the cuffed tube and is usually a temporary measure until the patient can control their own secretions. Cuffed tubes have a soft balloon around the distal end of the tube which inflates to seal the airway. Cuffed tubes are necessary when positive pressure ventilation is required or in situations where airway protection is essential to minimize aspiration of oral or gastric secretions (although cuffs are not an absolute barrier to secretions). If the tracheostomy tube lumen is occluded when the cuff is inflated, the patient will not be able to breathe around the tube, assuming the cuff is correctly positioned and inflated within the trachea.