Mobile oxygen supply gives patients freedom

January 6, 2010 9:45:08 AM PST
Nearly 1 million people in the United States require oxygen therapy 24 hours a day. Most patients suffer from lung conditions like emphysema, pulmonary fibrosis, pulmonary hypertension and inhalational burns. Some patients with heart disease and cystic fibrosis also require such therapy. Oxygen for long-term use comes in several different systems. At home, most patients use liquid and compressed gas systems, which involve large tanks. Smaller, more portable tanks can be used for a few hours outside the home. Oxygen is typically delivered through a two-pronged nasal tube, or cannula, but this method can be highly wasteful of oxygen. Other options include reservoir cannulas, which store oxygen in a small chamber when it is breathed out, and trans-tracheal catheters, which deliver oxygen directly into the trachea.

TRANS-TRACHEAL OXYGEN THERAPY: While oxygen therapy through a nasal cannula has been used successfully for decades, there have been cases of nasal prongs falling off during sleep, and many patients complain of discomfort around the nose and ears. A new supplemental oxygen system circumvents those issues by delivering oxygen directly through the trachea rather than through the nostrils. Research shows the system, called trans-tracheal oxygen therapy (TTOT), allows patients to be more active. This is because delivery through the trachea avoids the "dead space" of the nose, mouth and upper part of the trachea. The system also reduces oxygen flow requirements by 30 to 50 percent. That means oxygen sources last about twice as long as traditional oxygen therapy. One study shows patients on TTOT lived significantly longer than similar patients who used oxygen delivered through a nasal cannula. A major benefit for patients is improved self confidence, since they can wear the catheter on a necklace or hidden with a scarf and tubes are hidden under clothing.

To implant the TTOT system, surgeons make an incision in the neck and place a stent in. The next morning, the stent is removed and a catheter replaces it. Because this method of oxygen delivery requires surgery, there is a risk of bleeding in the neck and infection. There is also a risk of mucus buildup on the implanted catheter. Patients may experience pain shortly after the procedure. Patients who require a high amount of oxygen may not be candidates for TTOT since the catheter used to deliver oxygen is small.


Ellen McKenna
Public Relations
University of Virginia Health System
(434) 982-4490