Tracheostomy Care at every stage
Tracoe Twist & Twist Plus
Tracoe Twist and Twist Plus tracheostomy tubes are suitable for use at every stage of the patient journey from insertion to decannulation.
Enhanced airflow
Tracoe Twist and Twist Plus tracheostomy tubes are made from polyurethane and feature thin cannula walls while maintaining stability. The inner to outer diameter ratio is optimized allowing larger inner diameter tubes for increased airflow while minimizing the outer diameter of the tracheostomy tube. Proper ventilation and breathing depend on this enhanced air supply.
Since tracheostomy tubes impose different pressure and resistance than breathing through the upper airway,1 small changes in dimensions significantly impact respiratory workload.2 For example, if the inner diameter of the tracheostomy tube is reduced from 8mm to 7mm, the air supply is reduced by 41% (based on Hagen-Poiseuille equation for laminar flow). Therefore, every millimeter counts.
Optimal inside-outside diameter ratio
Tracheostomy tubes with a large inner diameter to reduce airway resistance and a small outer diameter to allow airflow around the tube are ideal. Twist Plus tubes are designed to meet these criteria. With even thinner walls than Twist tubes, the inner to outer diameter ratio is optimized.
Optimized subglottic suction
Tracoe Twist Extract and Tracoe Twist Plus Extract tubes feature an innovative design with a flat, subglottic suction channel that can be connected to a suction port to effectively remove secretions that pool above the cuff.
This advanced suction channel delivers significantly improved performance compared to the predecessor model, due to its larger flow cross-section and two strategically located suction points. As a result, secretions are suctioned more rapidly and thoroughly, ensuring enhanced efficiency.
Approved for above cuff vocalization
The Tracoe Extract tubes are approved for Above Cuff Vocalization (ACV). ACV is a voicing technique typically used with patients who are alert, cooperative, and require an inflated cuff. For ACV, the suction port in the Twist Extract and Twist Plus Extract tubes is used to introduce air or compressed oxygen into the subglottic lumen. This airflow travels into the upper airway restoring audible voice.3
Use of ACV has been shown to be safe, restore earlier communication, and improves quality of life.3,4,5 Additionally, improvements in swallow frequency and aspiration ratings with use of ACV have been reported.6
Features of the Inner and Outer Cannulas
Color identification for non-fenestrated tubes
- Green lettering on the neck flange
- Identified by a white locking ring
- Identified by white 15mm connectors
Tracoe Twist & Twist Plus features
Another special feature is the curved neck flange with double swivel that moves in both the vertical and horizontal axes, following the movements of the patient’s head.
The Twist and Twist Plus tubes are available in a variety of types including subglottic suction.
Tracoe Twist and Twist Plus tubes are made from polyurethane (PU), while the high-volume, low-pressure cuff is made from medical-grade PVC. All materials are free from DEHP.
References
- Pryor, L. N., Baldwin, C. E., Ward, E. C., Cornwell, P. L., O'Connor, S. N., Chapman, M. J., et al. Tracheostomy tube type and inner cannula selection impact pressure and resistance to air flow. Respiratory care. 2016; 61(5):607-614.
- Carter, A., S. J. Fletcher, and R. Tuffin. The effect of inner tube placement on resistance and work of breathing through tracheostomy tubes: a bench test. Anaesthesia. 2013; 68.3:276-282. 2012;24(4):401-406.
- Petosic, A., Viravong, M. F., Martin, A. M., Nilsen, C. B., Olafsen, K., & Berntzen, H. Above cuff vocalisation (ACV): A scoping review. Acta Anaesthesiologica Scandinavica. 2021; 65(1):15-25.
- Gajic S, Jacobs L, Gellentien C, Dubin RM, Ma K. Implementation of Above-Cuff Vocalization After Tracheostomy Is Feasible and Associated With Earlier Speech. Am J Speech Lang Pathol. 2024;33(1):51-56.
- Pandian, V., Cole, T., Kilonsky, D., Holden, K., Feller-Kopman, D. J., Brower, R., et al. Voicerelated quality of life increases with a talking tracheostomy tube: a randomized controlled trial. The Laryngoscope. 2020; 130(5):1249-1255.
- McGrath BA, Wallace S, Wilson M, et al. Safety and feasibility of above cuff vocalisation for ventilator-dependant patients with tracheostomies. J Intensive Care Soc. 2019;20(1):59-65.
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