Ulcerous tracheitis and mucus ball formation: a nearly fatal complication of a transtracheal oxygen catheter.
A transtracheal oxygen catheter may be superior to a nasal cannula. In particular, transtracheal oxygen therapy (TTOT) shows a 50% saving of oxygen consumption, a significant reduction of energy cost of breathing, and an improved patient compliance due to esthetic benefits and avoidance of mucosal injury by a nasal cannula. Most complications so far reported have been of minor clinical importance and could be treated easily. However, using the SCOOP technique, a serious complication has recently occurred in 1 of our patients. Soon after starting TTOT with a SCOOP-1 catheter he developed an ulcerous tracheitis and a severe tracheal obstruction by a mucus ball. To prevent further respiratory emergencies TTOT finally was stopped and the catheter replaced again by a nasal cannula. There is evidence that tracheal injury as well as the formation of mucus balls may be promoted by regular brushing the preliminary SCOOP-1 catheter which usually is left in place during the first weeks. As a result of this harmful experience, we recommend to reconsider carefully the indication for TTOT in patients with copious bronchial secretions and to avoid cleaning of the SCOOP-1 catheter with the rigid wire brush.
Borer
H
H
Department of Pulmonary Diseases, Clinic Barmelweid, Switzerland.
Frey
M
M
Keller
R
R
D000368:Aged; D002404:Catheterization / Q000009:adverse effects*; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000628:therapy; D008297:Male; D009093:Mucus; D010102:Oxygen Inhalation Therapy / Q000295:instrumentation*; D014133:Tracheal Diseases / Q000209:etiology; D014136:Tracheitis / Q000209:etiology*; D014456:Ulcer / Q000209:etiology