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Anaesthesia · Airway anatomy, equipment, and airway management: curriculum recognition
Sample itemA patient ventilated for 12 days after severe pneumonia fails repeated weaning trials because of high work of breathing and heavy secretions. The team replaces the translaryngeal tube with a surgical airway in the neck. Which benefit most directly helps weaning?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
B. Lower anatomical dead space and airway resistance
A tracheostomy bypasses the upper airway, which cuts dead space and resistance, eases secretion clearance and often permits less sedation, all of which help weaning. It does not prevent aspiration or ventilator-associated pneumonia and has its own complications, including tracheal stenosis.
Option by option
A. Abolition of the risk of ventilator-associated pneumonia
Ventilator-associated pneumonia still occurs with a tracheostomy.
B. Lower anatomical dead space and airway resistance (correct)
Correct. Less dead space and shorter, wider tubing lower the work of breathing.
C. Guaranteed prevention of subglottic stenosis
Stenosis can occur at the stoma or cuff site, so it is not prevented.
D. Complete protection of the lungs from aspiration
The cuff reduces but does not abolish aspiration of secretions.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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