Name of the Procedure:

Common Name: Transtracheal Oxygen Therapy (TTOT) Medical Term: Transtracheal Oxygen Catheter Insertion

Summary

Transtracheal oxygen catheter insertion is a procedure that places a small plastic catheter directly into the trachea (windpipe) to deliver oxygen more efficiently. This method bypasses the nose and mouth, providing a direct route for oxygen to reach the lungs.

Purpose

This procedure is used to provide supplemental oxygen in patients with chronic respiratory diseases. The goals are to improve oxygenation, reduce symptoms of breathlessness, and enhance the quality of life for patients requiring long-term oxygen therapy.

Indications

• Chronic Obstructive Pulmonary Disease (COPD)
• Interstitial lung disease
• Pulmonary hypertension
• Any condition that results in chronic hypoxemia (low blood oxygen levels)
• Patients who require high-flow oxygen

Preparation

• The patient may be instructed to avoid eating or drinking for a few hours before the procedure.
• Adjustments to medications, particularly blood thinners, may be necessary.
• Pre-procedure imaging studies such as chest X-rays or CT scans.
• Blood tests to ensure normal clotting function and oxygen levels.

Procedure Description

1. The patient is positioned, usually lying down or seated comfortably.
2. Local anesthetic is administered to numb the area around the trachea.
3. A small incision is made in the neck to access the trachea.
4. A narrow, flexible catheter is inserted through the incision and into the trachea.
5. The catheter is secured and attached to an oxygen supply.
6. The incision site is dressed, and instructions are provided for care.

Duration

The procedure typically takes about 30 minutes to 1 hour.

Setting

Transtracheal oxygen catheter insertion can be performed in a hospital, outpatient clinic, or a surgical center.

Personnel

• Pulmonologist or thoracic surgeon
• Nurses or respiratory therapists
• Anesthesiologist (if sedation is required)

Risks and Complications

• Infection at the incision site
• Bleeding
• Displacement or blockage of the catheter
• Tracheal injury
• Pneumothorax (collapsed lung)
• Granuloma formation (inflammatory tissue build-up)

Benefits

• Improved oxygen delivery
• Reduced need for supplemental oxygen from nasal cannulas or masks
• Increased mobility and convenience for the patient
• Potential improvement in the quality of life and reduction in hospital admissions

Recovery

• Follow-up visits to monitor the catheter site and oxygen levels.
• Instructions on daily care of the catheter to prevent infection.
• Gradual return to normal activities over a few days to weeks.
• Avoidance of strenuous activities initially; specific restrictions will vary based on the patient’s condition.

Alternatives

• Nasal cannula or face mask oxygen therapy
• Non-invasive ventilators
• Inhalers and medications
• Surgery for severe cases (like lung volume reduction surgery)

Pros of Alternatives:

• Non-surgical, lower risk
• May be more comfortable for some patients

Cons of Alternatives:

• Less efficient oxygen delivery
• May limit mobility due to equipment size and portability

Patient Experience

During the procedure, the patient may feel pressure or slight discomfort at the incision site. Post-procedure, patients might experience mild soreness, but this can usually be managed with over-the-counter pain relief. The enhanced oxygenation generally leads to a quick improvement in breathing comfort.

Proper education on catheter care and routine check-ups ensure a smooth recovery and effective use of the transtracheal oxygen catheter.