Rothe T B, Frey J G, Ciobanu T D, Karrer W
Luzerner Höhenklinik Montana.
Pneumologie. 1996 Oct;50(10):700-2.
A portable oxygen system in combination with transtracheal O2 delivery (SCOOP(R)) permits patients with respiratory failure optimal mobility and facilitates longterm oxygen therapy. This report describes a 70 year old female with COPD that developed acute respiratory distress 18 days after inserting PRESCOOP(R) and 11 days after changing to SCOOP 1 catheter. Catheter stripping had not revealed any pathology. Flexible bronchoscopy showed a mucus ball at the catheter tip leading to a 80% stenosis of the trachea. Trials to remove the ball with forceps and a loop were not successful until a rigid bronchoscop was inserted. Up to 10% of patients develop mucus ball formation with SCOOP 1 catheter which remains in situ for 6 weeks. In patients with high risk of mucus formation (high O2 flow, viscous mucus, low FEV1) the manufacturers of SCOOP recommend catheter stripping. We consider a control bronchoscopy being safer 1 week after changing from PRESCOOP to SCOOP because one patient has been reported to have died of this complication and our patient has developed a near fatal situation.
便携式氧气系统与经气管输氧装置（SCOOP®）相结合，可为呼吸衰竭患者提供最佳的活动能力，并便于长期氧疗。本报告描述了一名70岁的慢性阻塞性肺疾病（COPD）女性患者，在插入PRESCOOP® 18天后以及更换为SCOOP 1导管11天后出现急性呼吸窘迫。导管剥离未发现任何病变。可弯曲支气管镜检查显示导管尖端有一个黏液球，导致气管80%狭窄。在用镊子和圈套器尝试取出黏液球未成功后，插入硬支气管镜才成功取出。使用SCOOP 1导管原位留置6周的患者中，高达10%会形成黏液球。对于黏液形成风险高的患者（高氧流量、黏稠黏液、低第一秒用力呼气容积[FEV1]），SCOOP的制造商建议进行导管剥离。我们认为，从PRESCOOP更换为SCOOP 1周后进行支气管镜检查更为安全，因为曾有1例患者死于该并发症，而我们的患者也出现了近乎致命的情况。
