[Transtracheal oxygen therapy in obstructive sleep apnea syndrome]

In a prospective trial we studied the effect of nocturnal low-flow oxygen administration in 10 consecutive patients with obstructive sleep apnea. In 5 patients the clinical symptoms disappeared completely under nasal oxygen administration and hypoxic episodes decreased from an average of 28 to 3 per hour. In the remaining 5 patients nasal oxygen alone was not sufficiently effective. After insertion of a transtracheal catheter for nocturnal oxygen delivery, however, in 4 of these 5 patients (one patient refused the procedure) clinical symptoms improved and hypoxic episodes were reduced to 3 per hour (48/h without oxygen, 34/h with nasal oxygen). The favourable effect of transtracheal oxygen therapy may be due to the improved oxygenation provided by this technique, as well as to a "pneumatic splint" as a result of increased positive pressure in the central airways during prolonged apneic episodes. Thus, transtracheal oxygen therapy can be considered an efficient alternative to nasal CPAP in patients with severe obstructive sleep apnea syndrome.