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  • Title: Tracheal ulceration and obstruction associated with flexible Bivona tracheostomy tubes.
    Author: Tibballs J, Robertson C, Wall R.
    Journal: Anaesth Intensive Care; 2006 Aug; 34(4):495-7. PubMed ID: 16913349.
    Abstract:
    An adjustable length tracheostomy tube, Bivona, which assumes a curve on insertion, has a tendency to straighten itself in situ. The straightening force, measured electronically, was maximal (0.21 Newton) when a tube was bent 90 degrees. We observed particular clinical disadvantages of these tubes--that of tracheal ulceration (1 case), distortion of soft tracheal graft tissue (1 case) and airway obstruction when the tip embedded into the tracheal wall (1 case).
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