Transtracheal Oxygen Therapy

Reviewed by Ann Mullen, RN, CNS, AE-C, CDE, Michael D. Schwartz, MD, FACP, FCCM, FCCP

Oxygen is commonly delivered to the lungs by a small plastic tube called a nasal cannula. The tube is placed under the nostrils and delivers oxygen to the lungs. Oxygen can also be delivered to the lungs in other ways.

Transtracheal oxygen therapy (TTOT) is another method of delivering oxygen directly to the lungs. A small plastic tube (catheter) is inserted in the lower neck, which goes into the windpipe (trachea). The procedure should not be confused with a tracheotomy; they are entirely different.

TTOT has been used for long-term oxygen therapy and to treat chronic hypoxemia (low blood oxygen) for nearly 30 years. Over 26,000 people have used transtracheal oxygen during this period of time, the majority of whom have experienced a significant improvement in the quality of their lives. Transtracheal oxygen is more than a device for getting oxygen. It is a program of care.

TTOT has been shown to reduce oxygen-flow requirements by as much as 55 percent at rest and 30 percent during exercise. Because less oxygen is required, portable oxygen systems last longer and people can use smaller and lighter units.

When Is TTOT Considered?

TTOT is considered for any person who is on long-term oxygen therapy, desires an improvement in oxygen-flow requirements, is willing to participate in the program and will care for their catheter. Talk to your health care provider about whether TTOT is a good option for you.

Suggested candidates for TTOT include people who:

  • meet current guidelines for long-term oxygen therapy
  • are currently mobile outside of the home at least part of the time
  • are motivated to remain active
  • will comply with oxygen therapy and the proper care and cleaning of their catheter.

TTOT may also be appropriate for people who:

  • require higher oxygen flows and want to remain active by using lower flows via TTOT
  • don’t want to wear nasal cannula (tubes) due to irritation of the nose or nosebleeds.

Benefits of TTOT

TTOT can improve quality of life for people who have chronic lung diseases. Examples include chronic obstructive pulmonary disease (COPD), advanced fibrotic lung disease such as idiopathic pulmonary fibrosis (IPF), interstitial lung disease, bronchiectasis and a variety of other chest disorders.

TTOT may provide many benefits to people who require oxygen therapy. TTOT may:

  • reduce the amount of oxygen flow needed to achieve healthy oxygen levels
  • improve activity levels and mobility
  • improve exercise capacity
  • improve physical, social and mental function
  • improve the response to oxygen treatment
  • reduce length of hospitalization
  • empowers a person to get back to doing things they used to do
  • reduce shortness of breath (dyspnea)

As with any medical procedure, there are risks involved. Consult with your health care provider about these risks. 

Learn about the phases of TTOT care.         

National Jewish Health offers a transtracheal oxygen program. Our care team can evaluate and manage patients for whom transtracheal oxygen may be a good option for their long-term oxygen therapy. Talk with your health care provider if you have questions or are interested in TTOT.


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