Transtracheal catheter technique for pulmonary rehabilitation.

In over 100 chronic obstructive pulmonary disease patients, continuous oxygen therapy has been provided for up to 4 years using Micro-Trach percutaneous transtracheal catheters less than 2.0 mm in diameter. Successful rehabilitation has been achieved. Advances in materials, insertion technique, and protocols have simplified patient management. Complications occasionally encountered are bleeding, infection, subcutaneous emphysema, increased mucus production, and catheter failure or displacement. Long-term delivery of supplemental oxygen directly into the tracheobronchial tree eliminates the oxygen loss through the oral and nasal orifices that occurs when a nasal cannula is used. This closed system permits maintenance of therapeutic arterial blood levels with improved efficiency, greater comfort, and increased activity. The elimination of nasal irritation and cosmetic objections caused by nasal cannulas increases patient compliance, resulting in uninterrupted 24-hour-a-day oxygen use as indicated. The technique of inserting a transtracheal catheter and postinsertion management are discussed in detail.