Certified Respiratory Therapist Practice Exam

For a patient with a chronic neuromuscular condition requiring nocturnal positive pressure ventilation, what type of airway is best recommended?

1. Cuffed orotracheal tube

2. Standard tracheostomy tube

3. Fenestrated tracheostomy tube

4. Uncuffed endotracheal tube

The correct answer is: Standard tracheostomy tube

For a patient with a chronic neuromuscular condition who requires nocturnal positive pressure ventilation, the recommendation for a standard tracheostomy tube is based on several important considerations. First, a standard tracheostomy tube is designed to provide a stable airway and facilitate long-term ventilation support, which is essential for patients with neuromuscular conditions. These conditions often lead to respiratory muscle weakness, making it difficult for patients to maintain adequate ventilation. A tracheostomy allows for the secure delivery of positive pressure ventilation and can help manage airway secretions more effectively than other types of tubes. Additionally, when patients require long-term respiratory support, a standard tracheostomy tube minimizes the risk of airway complications and promotes patient comfort during extended use. It is less likely to induce complications that may arise from cuff pressure in cuffed tubes, such as tracheal ischemia or mucosal injury. Thus, the suitability of the standard tracheostomy tube for this patient population emphasizes safety, comfort, and effectiveness in managing chronic ventilation needs, particularly when transitioning to nocturnal ventilation support.