Transtracheal catheter acceptance and adverse events in long-term home oxygen therapy

The acceptance of transtracheal catheters (TTC) in chronic obstructive pulmonary disease (COPD) patients with severe hypoxaemia was analysed and the adverse events associated with this system of oxygenation described. Once the TTC (Oxycat) was inserted, each patient was monitored on an outpatient basis and information about the associated adverse events was collected. In a group of 70 patients that met the inclusion criteria, only 14 (20%) accepted TTC insertion. The observed adverse events were: haemorrhage through the stoma (3); ejection of the TTC in a cough reflex (2); subcutaneous emphysema (2); mucous plugging (1); and haemoptysis (1). Removal of the TTC was necessary in 29% of the cases, and was associated with the onset of an adverse event in all cases except one. Despite the proven benefits of oxygen therapy performance and the improvement in effort tolerance, transtracheal catheter has a low level of acceptance among patients with extremely disabling diseases. The adverse events observed were frequent, but could have been corrected and in no case worsened our patients' prognosis.