What are the benefits and risks of transtracheal oxygen therapy?

As with any other medical procedure, there are both benefits and risks associated with transtracheal oxygen therapy.
It is important that you discuss the benefits, risks, and your concerns with your physician or respiratory therapist.
They can provide more insights and information relating specifically to your situation than we possibly could here. Remember, this is only a guide. Always follow your doctors instructions and immediately notify your doctor of any concerns or difficulties you may experience.

Benefits include:

Improved Comfort and Convenience: The catheter is usually a great deal more comfortable than the nasal cannula. Unlike the nasal cannula, it avoids the irritation of the ears and nose, and doesn't get in the way when you're eating, shaving, putting on makeup, talking on the phone or even kissing.

Improved Self Image: Everyone likes to look their best, and sometimes that can be hard to do with a nasal cannula. The small catheter and connecting tube can be easily hidden under your clothing, and eliminates the unsightly nasal cannula from your face.

Lower Oxygen Requirements: Because the transtracheal catheter delivers the oxygen right where it's needed, it reduces resting oxygen requirements in most patients by 50-60%. Transtracheal oxygen allows individuals to use their portable oxygen system more frequently and for longer periods of time. Therefore, the total amount of oxygen consumption may not decrease as much as projected.

Increased Mobility: Lower oxygen requirements allow most transtracheal oxygen patients to use lighter and more compact oxygen sources. Although smaller, these sources often last longer, allowing more time away from home. Many people also report increased mobility because of better endurance while walking. The ability to be away from home for shopping, socializing with friends, doing errands, or working allows enjoyment of a fuller life.

Greater Exercise Capacity: Since transtracheal oxygen delivery is more efficient, patients that use transtracheal oxygen tend to be more active and usually recover more quickly from activities that require exertion. We don't promise that you'll be able to run the Boston Marathon, but day to day activities involving walking, lifting, moving, even dancing might just become a little easier.

True 24 Hour Per Day Oxygen Therapy: It is difficult for many oxygen patients to wear their nasal cannula every minute of every day because they are so uncomfortable. Transtracheal oxygen therapy eliminates the sore nose, sore ears, sinus problems, and dry eyes at night, nasal congestion and runny nose associated with the nasal cannula and makes it possible to receive oxygen 24 hours a day. You may find that getting your oxygen 24 hours a day increases your energy, activity, thought clarity, helps you sleep better and makes you feel much healthier in general.

Improved Sense of Smell, Taste and Appetite: Without the difficulties of the nasal cannula, many patients report an improvement in these areas.

Physiological benefits include:

Reduced Red Blood Cell Count: For some patients with chronically low blood oxygen levels, the body increases the number of red blood cells in an attempt to compensate for the low oxygen levels. The excess of red blood cells causes the blood to get thicker, which places a strain on the heart. Transtracheal oxygen therapy can help normalize this situation by delivering oxygen on a 24-hour basis. As the body's oxygen levels increase, it no longer needs those extra red blood cells to transport oxygen, and this decreases red blood cell count, reducing stress on the heart.

Improved Blood Flow Through The Lungs: When blood oxygen levels are chronically low, the small blood vessels in the lungs constrict, making it harder for the heart to pump blood through the lungs. Because transtracheal oxygen therapy provides oxygen on a 24 hour basis, it can raise blood oxygen levels which reduces the constriction effect. This ultimately reduces the workload and stress on the heart.

Improvements in Oxygenation During Sleep: Because the TTOP catheter is never out of the windpipe, your oxygen will be delivered all night while you sleep. This is unlike the nasal cannula, which can fall out of place at night. Many TTO patients report sleeping better on transtracheal oxygen therapy.

Decreased Work of Breathing: Since transtracheal oxygen therapy delivers oxygen directly into the lungs, it bypasses the nose, mouth, and nearly all of the trachea (windpipe) Because it avoids those areas and goes directly to the lungs, many transtracheal oxygen patients experience a reduction in their work of breathing or shortness of breath (the amount of energy that must be used to breathe). This can make a big difference in how mobile and active a patient can be.

Reduced Hospital Days: Several studies have documented reduced hospitalizations when patient hospital days are compared before and after starting transtracheal oxygen therapy. A decrease in hospital costs has also been documented. A study done at a community hospital involving over 160 patients confirmed that transtracheal oxygen patients lived significantly longer (average of 24 months) than clinically similar (age, sex, lung disease, and lung function) nasal cannula patients. This is probably due to the fact that patients are truly getting their oxygen 24 hours per day, and better oxygenation is beneficial to the other organ systems of the body such as the heart, kidneys, liver, and brain.

Potential Risks include: Some of the minor side effects of transtracheal oxygen therapy are normal and really aren't complications. It is normal, for example, to have some discomfort around the tract and coughing after the transtracheal procedure. Typically, plain Tylenol and a mild cough suppressant are enough to make you comfortable. Some individuals tend to get collections of mucus near the tip of the catheter for the first two to three weeks after the procedure, which can cause coughing. After your trachea gets used to the catheter, and when you start removing the catheter daily to clean it, mucus collections stop being a problem. It is possible that your catheter may come out and you cannot get it back into your trachea. This is NOT a medical emergency. Put your nasal cannula on and call your physician. He/She will direct you in what to do.

Complications that have been observed but were judged to be uncommon and usually minor or moderate in severity are:

  • Wheezing triggered by the catheter in asthmatics (bronchospasm)
  • Bubbles under the skin of the neck (subcutaneous emphysema)
  • Low grade infection of the cartilage of the windpipe (chondritis)
  • Small growths of scar tissue around the tract opening (keloids)

Complications that have not been observed to date but which are theoretically possible include:

  • Pneumonia
  • Infection of the tract (abscess)
  • Collapse of a lung (pneumothorax)
  • Serious bleeding
  • Lung Failure
  • Death