Transtracheal oxygen delivery.

Conventional tracheostomies have been used for many years to deliver oxygen with the patient breathing spontaneously or in conjunction with positive pressure ventilators. The insertion of a transtracheal catheter specifically to deliver oxygen, however, dates only from Heimlich's studies published in 1982.' He showed that in dogs and man a normal oxygen saturation could be maintained by the delivery of oxygen directly into the trachea. He developed a percutaneous catheter suitable for clinical use, and has subsequently shown that it is satisfactory for long term use and that most patients preferred it to the conventional oxygen delivery systems.2 The impetus for the refinement of transtracheal catheters came from the opportunities that they give to conserve oxygen and to cut the costs of domiciliary oxygen treatment.