A program for transtracheal oxygen delivery. Assessment of safety and efficacy.

Over a 2-year period, the safety and efficacy of a program specifically designed for transtracheal oxygen therapy were evaluated in 100 patients with chronic hypoxemia. The four clinically defined phases of the program included patient orientation, evaluation, and selection (phase I); a new needle-wire guide-dilator transtracheal procedure and stent week (phase II); transtracheal oxygen delivery with an immature tract (phase III); and transtracheal oxygen delivery with a mature tract (phase IV). Sequelae and complications were minor, and patient acceptance was high. As compared with the nasal cannula, the transtracheal catheter was associated with a significant reduction in oxygen flow requirement during both rest and exercise. Adequate oxygenation was maintained over time, and erythrocythemia was alleviated with transtracheal delivery. We conclude that transtracheal oxygenation by this method has a low, acceptable morbidity; it is more efficient than nasal cannula delivery and may be more effective in some patients.