THE PRIMARY AIM of tracheostomy is to increase the efficiency of respiration while minimizing the work required for breathing. The purpose of oxygen therapy is to provide optimum tissue oxygenation by increasing arterial oxygen saturation. Therefore, in those patients requiring tracheostomy and oxygen therapy, the method of administration of oxygen should be one that not only increases the arterial oxygen saturation but also does not impose a greater work requirement for breathing and, consequently, a greater need for oxygen. With these points in mind, we decided to investigate the resistance factors associated with the procedure of inserting a catheter into a tracheostomy tube for the administration of oxygen.
That this procedure is frequently used is evidenced by a report of "errors" in oxygen administration by Kracum.1 He reported that over 50% of 45 civilian hospitals he surveyed between 1956 and 1958 used the catheter method for oxygen administration to
Gunn IP, Jenicek JA, Lewis BJ, Meyer JA. Expiratory Resistance of Oxygen Catheters in Patients With Tracheostomies. JAMA. 1965;193(9):737–739. doi:10.1001/jama.1965.03090090043016