Addition of Nasal Cannula Can Either Impair or Enhance Preoxygenation With a Bag Valve Mask: A Randomized Crossover Design Study Comparing Oxygen Flow Rates

McQuade, David; Miller, Matthew; Hayes‐Bradley, Clare

doi:10.1213/ane.0000000000002341

Cited by 12 publications

(8 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The patients' SpO 2 has never been lower than 91%. After using HFNC, it is expected to extend the apnea time, but in this process, carbon dioxide level monitoring is required [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

High-flow nasal cannula in nonlaser microlaryngoscopic surgery: a prospective study of 19 cases in a chinese population

Liu

Wang

et al. 2022

BMC Anesthesiol

View full text Add to dashboard Cite

Background High-flow nasal cannula (HFNC) is a new type of oxygen therapy, but its application in surgery remains unclear, we tried to describe the application of HFNC in microlaryngoscopic surgery for the Chinese population. Methods Nineteen adults, American society of anesthesiology class (ASA) 1–2 patients with body mass index < 30 kg.m−2 underwent microlaryngoscopic surgery using HFNC for airway management. Outcomes included apnoea time, intraoperative oxygenation, carbon dioxide value, lactate value, and the relationship between the duration of apnoea time and carbon dioxide levels. Results A total of 19 patients underwent vocal cord tumor resection under a microlaryngoscope with HFNC as the sole method of ventilation. The mean age was 39.7 years old, and the mean BMI was 23.9 kg.m−2. The mean apnea time was 21.5 min. The SpO2 of 18 patients remained above 90%, and only 1 patient dropped to 88%. The average basal lactate and highest lactate value was 0.58 mmol. L−1 and 0.68 mmol.L−1. The difference between basal and highest lactate values was statistically significant (P < 0.05). The average highest PaCO2 value was 79.4 mmHg. The PaCO2 increased by 1.68 ± 0.12 mmHg every minute linearly. Conclusions In the case series we have observed that HFNC would be safe and effective oxygenation and ventilation technique for selected Chinese patients undergoing non-laser microlaryngoscopic surgery within 30 min. The tubeless technology reduces the complications of tracheal intubation and jet ventilation and clears the surgical field of vision. Trial registration Chinese Clinical Trial Registry (ChiCTR100049144).

show abstract

“…The patients' SpO 2 has never been lower than 91%. After using HFNC, it is expected to extend the apnea time, but in this process, carbon dioxide level monitoring is required [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

High-flow nasal cannula in nonlaser microlaryngoscopic surgery: a prospective study of 19 cases in a chinese population

Liu

Wang

et al. 2022

BMC Anesthesiol

View full text Add to dashboard Cite

show abstract

“…Previous studies have investigated the optimal strategy for preoxygenation, but so far these have only been completed on healthy volunteers or stable patients in the OR. [16][17][18][19][20][21][22][23] Given clinicians used the BVM in nearly 90% of patients in the study group our results suggest that utilizing a BVM allows a good mask seal and real-time feedback with ETO 2 monitoring, which may therefore lead to better preoxygenation.…”

Section: Discussionmentioning

confidence: 99%

Emergency physician use of end‐tidal oxygen monitoring for rapidsequence intubation

et al. 2020

View full text Add to dashboard Cite

Background End‐tidal oxygen (ETO 2 ) monitoring is used by anesthesiologists to quantify the efficacy of preoxygenation before intubation but is generally not used in emergency departments (EDs). We have previously published our findings describing preoxygenation practices in the ED during blinded use of ETO 2 . The purpose of this investigation is to determine whether the unblinded use of ETO 2 monitoring led to improvements in preoxygenation during rapid sequence intubation in the ED and also the oxygen device or technique changes that were used to achieve higher ETO 2 levels. Methods We conducted an interventional study at 2 academic EDs in Sydney, Australia and New York City, New York using ETO 2 monitoring to investigate the preoxygenation process and effectiveness. We used data collected during a previous descriptive study for the control group, in which care teams in the same 2 EDs were blinded to the ETO 2 value. In the study group, clinicians could utilize ETO 2 to improve preoxygenation. Following an education process, clinicians were able to choose the method of preoxygenation and the techniques required to attempt to achieve an ETO 2 level >85%. The primary outcome was the difference in ETO 2 levels at the time of induction between the control and study group and the secondary outcome included the methods that were attempted to improve preoxygenation. Results A convenience sample of 100 patients was enrolled in each group. The median ETO 2 level achieved at the time of induction was 80% (interquartile range 61 to 86, overall range 73) in the control group and 90% in the study group (interquartile range 83 to 92, overall range 41); the median difference was 12 (95% confidence interval: 8, 16, P = < 0.001). The majority of oxygen device changes were from non‐rebreather mask to bag‐valve‐mask (BVM) (15%, n = 15) and changes in technique from improvements in mask seal (54%, n = 34). The final device used in the study group was BVM in 87% of cases. Conclusions In 2 clinical studies of ETO 2 in academic EDs, we have demonstrated that the use of ETO 2 is feasible and associated with specific and potentially improved approaches to preoxygenation. A clinical trial is needed to further study the impact of ETO 2 on the preoxygenation process and the rate of hypoxemia.

show abstract

“…[24] McQuade et al found an increase in end tidal oxygenation (EtO2) with NC at rates >15 LPM, deleterious effect with <5LPM, and no benefit when an adequate seal was achieved with BVM alone, as the addition of NC disrupted the mask seal, potentially explaining the study results by Caputo. [29] Yet, in cases of with a mask leak, there was benefit from adding the nasal cannula. [29] Russotto found that apneic oxygenation with low flow or high flow nasal cannula decreased desaturation.…”

Section: Apneic Oxygenationmentioning

confidence: 99%

“…[29] Yet, in cases of with a mask leak, there was benefit from adding the nasal cannula. [29] Russotto found that apneic oxygenation with low flow or high flow nasal cannula decreased desaturation. [16] A 2016 study by Sakles and Mosier et al demonstrated increased first pass success without hypoxia in patients with apneic oxygenation, though it should be noted that these patients were primarily intubated for airway protection and traumatic injuries.…”

Section: Apneic Oxygenationmentioning

confidence: 99%

Preoxygenation and Apneic Oxygenation in Emergency Airway Management

Barbosa,

Mosier

2024

Clin Exp Emerg Med

View full text Add to dashboard Cite

Objective: Preoxygenation during the peri-intubation period is now considered a critical aspect of rapid sequence intubation and an important skill for emergency medicine and critical care providers. Peri-intubation hypoxemia carries significant risk, including cardiac arrest, and care must be taken for appropriate management including through apnea and initiation of laryngoscopy. Appropriate selection of preoxygenation devices should depend on underlying physiology to optimize oxygenation prior to intubation attempts. Methods: A PubMed Medline search. was completed with selection of articles from March 2008 to March 2023 describing various techniques for preoxygenation for intubation in the critical care and operating room setting with pregnant and obese patient populations included.Prehospital and pediatric populations were excluded in this review.Outcomes: This review provides an overview of methods of preoxygenation with their clinical indications as well as methods for determining end points to preoxygenation and apneic oxygenation. An overview of approaches to preoxygenation was included for patients considered to have a physiologically difficult airway and obese and pregnant patient populations.

show abstract

Addition of Nasal Cannula Can Either Impair or Enhance Preoxygenation With a Bag Valve Mask: A Randomized Crossover Design Study Comparing Oxygen Flow Rates

Cited by 12 publications

References 18 publications

High-flow nasal cannula in nonlaser microlaryngoscopic surgery: a prospective study of 19 cases in a chinese population

High-flow nasal cannula in nonlaser microlaryngoscopic surgery: a prospective study of 19 cases in a chinese population

Emergency physician use of end‐tidal oxygen monitoring for rapidsequence intubation

Preoxygenation and Apneic Oxygenation in Emergency Airway Management

Contact Info

Product

Resources

About