Borer H, Frey M, Keller R
Department of Pulmonary Diseases, Clinic Barmelweid, Switzerland.
Respiration. 1996;63(6):400-2. doi: 10.1159/000196586.
A transtracheal oxygen catheter may be superior to a nasal cannula. In particular, transtracheal oxygen therapy (TTOT) shows a 50% saving of oxygen consumption, a significant reduction of energy cost of breathing, and an improved patient compliance due to esthetic benefits and avoidance of mucosal injury by a nasal cannula. Most complications so far reported have been of minor clinical importance and could be treated easily. However, using the SCOOP technique, a serious complication has recently occurred in 1 of our patients. Soon after starting TTOT with a SCOOP-1 catheter he developed an ulcerous tracheitis and a severe tracheal obstruction by a mucus ball. To prevent further respiratory emergencies TTOT finally was stopped and the catheter replaced again by a nasal cannula. There is evidence that tracheal injury as well as the formation of mucus balls may be promoted by regular brushing the preliminary SCOOP-1 catheter which usually is left in place during the first weeks. As a result of this harmful experience, we recommend to reconsider carefully the indication for TTOT in patients with copious bronchial secretions and to avoid cleaning of the SCOOP-1 catheter with the rigid wire brush.
经气管给氧导管可能优于鼻导管。特别是，经气管给氧疗法（TTOT）可节省50%的氧气消耗，显著降低呼吸的能量消耗，并且由于美观优势以及避免鼻导管造成的黏膜损伤，患者的依从性有所提高。目前报道的大多数并发症临床意义不大，且易于治疗。然而，使用SCOOP技术时，我们的一名患者最近出现了严重并发症。在开始使用SCOOP-1导管进行TTOT后不久，他患上了溃疡性气管炎，并因黏液球导致严重的气管阻塞。为防止进一步的呼吸急症，最终停止了TTOT，并再次将导管更换为鼻导管。有证据表明，定期刷洗最初的SCOOP-1导管（通常在最初几周留在原位）可能会促进气管损伤以及黏液球的形成。鉴于这种不良经验，我们建议仔细重新考虑TTOT在支气管分泌物过多患者中的适应证，并避免使用硬钢丝刷清洁SCOOP-1导管。
