Diffusion in anaesthesia

Sleath, G. W.; Jenkins, Leonard C.; Graves, H. B.

doi:10.1007/bf03020165

Cited by 8 publications

(5 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the apnoeic patient, extraction of oxygen from the alveolus into the blood causes alveolar pressure to become subatmospheric, generating a pressure gradient which enables the movement of additional administered oxygen into the alveolus . This is termed ‘aventilatory mass flow’ , formerly referred to as ‘diffusion respiration’ or ‘apnoeic diffusion of oxygenation’ .…”

Section: Physiologymentioning

confidence: 99%

Uses and mechanisms of apnoeic oxygenation: a narrative review

Lyons

Callaghan

2019

Anaesthesia

View full text Add to dashboard Cite

Apnoeic oxygenation refers to oxygenation in the absence of spontaneous respiration or mechanical ventilation. It has been described in humans for over half a century and has seen a resurgence in interest given its potential to delay oxygen desaturation during airway management, especially with the advent of high-flow nasal cannulae. This narrative review summarises our current understanding of the mechanisms of gas exchange during apnoeic oxygenation and its diverse range of clinical applications, including its use at induction of anaesthesia and for the facilitation of 'tubeless anaesthesia'. Additional discussion covers use in critical care, obese, obstetric and paediatric sub-populations. The article also highlights current research efforts aiming to enhance the evidence base for the use of this technique.

show abstract

Section: Physiologymentioning

confidence: 99%

Uses and mechanisms of apnoeic oxygenation: a narrative review

Lyons

Callaghan

2019

Anaesthesia

View full text Add to dashboard Cite

show abstract

“…Apneic oxygenation (AP OX) is a concept that has been understood for decades based on studies performed in the operating room . It, however, has only recently been evaluated for use during emergency intubation .…”

mentioning

confidence: 99%

First Pass Success Without Hypoxemia Is Increased With the Use of Apneic Oxygenation During Rapid Sequence Intubation in the Emergency Department

et al. 2016

View full text Add to dashboard Cite

Objectives: The objective was to determine the effect of apneic oxygenation (AP OX) on first pass success without hypoxemia (FPS-H) in adult patients undergoing rapid sequence intubation (RSI) in the emergency department (ED).Methods: Continuous quality improvement data were prospectively collected on all patients intubated in an academic ED from July 1, 2013, to June 30, 2015. During this period the use of AP OX was introduced and encouraged for all patients undergoing RSI in the ED. Following each intubation, the operator completed a standardized data form that included information on patient, operator, and intubation characteristics. Adult patients 18 years of age or greater who underwent RSI in the ED by emergency medicine residents were included in the analysis. The primary outcome was FPS-H, which was defined as successful tracheal intubation on a single laryngoscope insertion without oxygen saturation falling below 90%. A multivariate logistic regression analysis was performed to determine the effect of AP OX on FPS-H.Results: During the 2-year study period, 635 patients met inclusion criteria. Of these, 380 (59.8%) had AP OX utilized and 255 (40.2%) had no AP OX utilized. In the AP OX cohort the FPS-H was 312/380 (82.1%) and in the no AP OX cohort the FPS-H was 176/255 (69.0%) (difference = 13.1%, 95% confidence interval [CI] = 6.2% to 19.9%). In the multivariate logistic regression analysis, the use of AP OX was associated with an increased odds of FPS-H (adjusted odds ratio = 2.2, 95% CI = 1.5 to 3.3). Conclusions:The use of AP OX during the RSI of adult patients in the ED was associated with a significant increase in FPS-H. These results suggest that the use of AP OX has the potential to increase the safety of RSI in the ED by reducing the number of intubation attempts and the incidence of hypoxemia.ACADEMIC EMERGENCY MEDICINE 2016;23:703-710

show abstract

“…This pressure gradient allows for the movement of additional oxygen from the administered oxygen source (such as a mask or nasal cannula) into the alveoli. The subatmospheric alveolar pressure created during apnea facilitates the flow of oxygen into the alveoli, even in the absence of active ventilation (Figure 1 ) [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Apneic Oxygenation: A Summarized Review and Stepwise Approach

Fayed,

Maroun,

Patel

et al. 2023

Cureus

View full text Add to dashboard Cite

Apneic oxygenation is a technique used during airway management procedures to maintain oxygenation and prevent desaturation during a lack of ventilation. Despite its importance, there is a lack of comprehensive information on how to achieve effective apneic oxygenation, leading to misunderstandings and suboptimal utilization of this technique. Apneic oxygenation involves several key steps. Firstly, patient selection is crucial, considering factors such as anticipated difficulty with airway management, reduced functional residual capacity, increased oxygen consumption, and medical conditions associated with impaired oxygenation. Secondly, adequate preoxygenation is essential to optimize oxygen reserves before the onset of apnea, utilizing methods like non-rebreather oxygen masks or specific breathing techniques. Thirdly, maintaining airway patency through techniques such as jaw thrust or nasopharyngeal airway placement allows for unobstructed airflow during the apneic period. Lastly, the selection of the appropriate oxygen delivery method, such as high-flow nasal oxygen or nasal cannula, depends on the patient's existing respiratory support. Despite the growing body of literature on apneic oxygenation, current review articles often lack a stepwise approach for its proper execution. This knowledge gap contributes to the misunderstanding and underutilization of this important tool during intubation and airway management. In conclusion, apneic oxygenation is a valuable technique for maintaining oxygenation during periods of apnea. However, the lack of comprehensive information and stepwise guidance in the current literature hinders its optimal utilization. Clear guidelines and educational resources should be developed to address this knowledge gap and ensure the safe and effective implementation of apneic oxygenation. By following a stepwise approach that includes patient selection, adequate preoxygenation, airway patency, and appropriate oxygen delivery, healthcare providers can enhance patient outcomes and minimize the risk of desaturation during airway management procedures.

show abstract

Diffusion in anaesthesia

Cited by 8 publications

References 31 publications

Uses and mechanisms of apnoeic oxygenation: a narrative review

Uses and mechanisms of apnoeic oxygenation: a narrative review

First Pass Success Without Hypoxemia Is Increased With the Use of Apneic Oxygenation During Rapid Sequence Intubation in the Emergency Department

Apneic Oxygenation: A Summarized Review and Stepwise Approach

Contact Info

Product

Resources

About