What is a complication of long-term use of high cuff pressures?

Tracheoesophageal fistula is indeed a potential complication of long-term use of high cuff pressures. When cuff pressures are excessively high, they can exert significant pressure on the trachea and surrounding tissues. Over time, this pressure can compromise the integrity of the tracheal wall, leading to ischemia and necrosis. If the trachea becomes sufficiently damaged, it can create a pathological connection between the trachea and the esophagus, resulting in a tracheoesophageal fistula. This complication can lead to serious clinical issues, such as aspiration and infection, making it a critical concern in the management of patients requiring prolonged mechanical ventilation.

While the other options may reflect potential issues related to cuff pressures, they do not capture the specific and direct mechanism that leads to the formation of a tracheoesophageal fistula in the context of inappropriate cuff pressure management.