The twist and twist plus tracheostomy tubes with inner cannula system are available with and without low-pressure cuff, with and without fenestration or double fenestration and with subglottic suction (twist extract and twist plus extract).
The movable neck flange with curved flange shape has a cardanic suspension and thus follows the patient's head movements.
The twist and twist plus tubes are characterized by thin-walled, stable cannula walls and a good fit of the inner cannula in the outer cannula. This allows a good inner–outer diameter ratio. The indicated cannula size corresponds to the inner diameter of the inner cannula. The largest possible lumen should be available for breathing and ventilation - therefore the inner value is what counts here. For the patients, every millimetre is crucial. If the diameter is reduced from 8 to 7 mm, the air supply is 41% smaller and breathing becomes more difficult. A change from 8 to 9 mm improves the value by 60%, while the work of breathing remains the same.** Law of fluid mechanics according to Hagen-Poiseuille
Fenestrated twist and twist plus tracheostomy tubes have a multiple fenestration at the outer bend. The twist plus tracheostomy tubes are distinguished by a double fenestration: in addition to the fenestration at outer bend it has two phonation openings at inner bend. These provide additional space for the exhaled air to reach the upper airways.
Green sign lettering means non-fenestrated outer cannula
non-fenestrated inner cannulas of the twist line are recognizable by white 15 mm connectors
non-fenestrated inner cannulas of the twist plus line are recognizable by a white locking ring
Blue shield lettering means fenestrated outer cannula
fenestrated inner cannulas of the twist line are recognizable by blue 15 mm connectors
fenestrated inner cannulas of the twist plus line are recognizable by a blue locking ring
The TRACOE twist extract tracheostomy tubes has a suction catheter attached to the outer cannula with the suction opening at the lowest possible point above the low-pressure cuff.
The TRACOE twist plus extract tracheostomy tubes have a new, flat and stable suction channel and significantly improve the suction behaviour compared to the suction catheter. The larger flow cross-section and the lower suction point enable efficient extraction: compared to the previous model, secretions are extracted more quickly and without residues. The TRACOE extract tracheostomy tubes are also approved for ACV - Above Cuff Vocalisation or "speaking under ventilation".
In addition, the twist and twist plus extract tracheostomy tubes are available with an additional fenestration or double fenestration as a multifunctional tracheostomy tube. This means that they can be used with a closed inner cannula and inflated cuff for ventilation and with an unblocked cuff and unwindowed or fenestrated inner cannula for phonation.
After a percutaneous dilation tracheotomy (PDT) has been performed and for reinsertion and/or a difficult tracheostomy tube change with a percutaneously created tracheostoma, the twist and twist plus tracheostomy tubes are also already available pre-installed on a minimally traumatic insertion system (P-tubes) according to the Seldinger technique. These are adapted to the respective tube shape and length.
The colour coding and symbols on the outer packaging are intended to help you immediately understand the property(ies) of this tracheostomy tube. All twist and twist plus outer packages are marked accordingly. This facilitates quicker access, irrespective of the mostly very different storage options and systems.
The TRACOE smart Cuff Manager monitors and regulates the internal pressure in low-pressure cuffs of tracheostomy tubes and endotracheal tubes. The cuff pressure is maintained between 20 and 30 cmH₂O. The blue buffer balloon is used for visual control.
To increase patient safety, the TRACOE phon assist I Speaking Valve is also available in orange. The bright orange color is unmistakable and distinguishes it from the other attachments, making it clearly identifiable as a speaking valve.
