[Dangerous complication of transtracheal oxygen therapy with the SCOOP(R) system].
A portable oxygen system in combination with transtracheal O2 delivery (SCOOP(R)) permits patients with respiratory failure optimal mobility and facilitates longterm oxygen therapy. This report describes a 70 year old female with COPD that developed acute respiratory distress 18 days after inserting PRESCOOP(R) and 11 days after changing to SCOOP 1 catheter. Catheter stripping had not revealed any pathology. Flexible bronchoscopy showed a mucus ball at the catheter tip leading to a 80% stenosis of the trachea. Trials to remove the ball with forceps and a loop were not successful until a rigid bronchoscop was inserted. Up to 10% of patients develop mucus ball formation with SCOOP 1 catheter which remains in situ for 6 weeks. In patients with high risk of mucus formation (high O2 flow, viscous mucus, low FEV1) the manufacturers of SCOOP recommend catheter stripping. We consider a control bronchoscopy being safer 1 week after changing from PRESCOOP to SCOOP because one patient has been reported to have died of this complication and our patient has developed a near fatal situation.
Rothe
T B
TB
Luzerner Höhenklinik Montana.
Frey
J G
JG
Ciobanu
T D
TD
Karrer
W
W
D000368:Aged; D000402:Airway Obstruction / Q000209:etiology*; D001999:Bronchoscopy; D002408:Catheters, Indwelling; D004868:Equipment Failure; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation; D008173:Lung Diseases, Obstructive / Q000628:therapy*; D009093:Mucus; D010102:Oxygen Inhalation Therapy / Q000295:instrumentation*; D014135:Tracheal Stenosis / Q000209:etiology*