Abstract
Long-term oxygen therapy requires a practical regulated oxygen delivery system which works in the home. Although face-masks are cheap and efficient, they are awkward and need removal for talking and eating. Few patients would comply with this for 15 h her day. Nasal prongs are reliable, cheap, safe and well tolerated but are wasteful of oxygen. This waste is important both practically and financially when oxygen is supplied from portable or large cylinders or from a liquid source. The Oxymizer pendants and moustache or inspiration phased delivery devices improve nasal prong efficiency. Nasopharyngeal catheters are an alternative but more invasive means of oxygen conservation. Percutaneous transtracheal catheterization is both oxygen efficient and cosmetically acceptable. As it requires an invasive surgical procedure with some serious potential complications its use should probably be reserved for those patients in whom adequate oxygenation is not achieved by standard nasal prongs. Its use is rarely justified on merely cosmetic grounds. Permanent tracheostomy is not indicated in most cases of hypoxic chronic obstructive airways disease (COAD). Nasal prongs would seem the most reasonable method of oxygen delivery. Their use with oxygen concentrators lessens the need for oxygen conservation.
