Transtracheal oxygen: a step beyond the nasal cannula for long-term oxygen therapy.

Transtracheal oxygen represents an important advance in the technology of long-term oxygen therapy. As an oxygen conserving technique, it allows increased physical activity with smaller ambulatory and portable units and facilitates the management of patients with refractory hypoxemia outside of the hospital. There is increasing evidence that transtracheal oxygen therapy provides significant physiologic benefits beyond those achieved with the nasal cannula because of tighter control of oxygen therapy and fewer episodes of hypoxemia as a result of uninterrupted 24-hour oxygen therapy. Transtracheal oxygen therapy should be viewed as a program for long-term oxygen administration and not simply as a procedure that involves the insertion of a catheter into the tracheal. Careful patient screening and patient education is important to avoid complications. The program is best administered through regional centers with a team approach to patient care.