Is adequate preoxygenation about more than just 3 minutes?

Jarvis, Jeffrey L.; King, Terri

doi:10.1002/emp2.12291

Cited by 1 publication

(2 citation statements)

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“…Although the EtO 2 is a ventilator parameter used in clinical practice, it is not monitored routinely (41). The importance of EtO 2 has been emphasized in emergency departments, wherein rapid sequence intubation is commonly performed (42,43); EtO 2 monitoring improved the quality of preoxygenation, resulting in a reduction in hypoxemic events during intubation (44). Adequate preoxygenation confirmed by EtO 2 monitoring will improve patient safety by checking for the presence of a leak and optimizing oxygen wash-in, which makes the induction of anesthesia more comfortable and relaxed.…”

Section: Discussionmentioning

confidence: 99%

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Efficacy of preoxygenation with end-tidal oxygen when using different oxygen concentrations in patients undergoing general surgery: a single-center retrospective observational study

et al. 2022

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Background: Preoxygenation is a simple but very important procedure for preventing arterial desaturation.A higher fraction of inspired oxygen (FiO 2 ) increases atelectasis and 80% oxygen results in significantly less atelectasis than 100% oxygen. We investigated whether there was a difference in the duration of adequate preoxygenation when using 100% and 80% oxygen. The proportion of patients for whom >3 min was required to achieve adequate preoxygenation was also investigated. Methods: The VitalDB database of patients underwent general surgery between February 1, 2021 and November 12, 2021 was reviewed. The time between the start of preoxygenation and the point where a 10% difference between FiO 2 and end-tidal oxygen (EtO 2 ) was defined as the preoxygenation time. The patients were classified into 100% and 80% groups according to the oxygen concentration. Propensity score matching (PSM) was performed to control for potential confounding factors. Results: Only 330 of the 1,377 patients had sufficient data for analysis: 179 in the 80% group and 151 in the 100% group. After PSM, 143 patients in each group were analyzed. The median preoxygenation time was 143 s [interquartile range (IQR): 120.5-181.5 s] and 144 s (IQR: 109.75-186.25 s) in the 80% and 100% groups, respectively [P=0.605; median difference =−1 s; 95% confidence interval (CI): −13 to 10]. Of the patients, 27% required >3 min for adequate preoxygenation.Conclusions: No difference in preoxygenation time was found between the 80% and 100% groups. For some patients, breathing for 3 min is not sufficient for adequate preoxygenation. EtO 2 monitoring aids evaluation of whether preoxygenation was adequate.

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Section: Discussionmentioning

confidence: 99%

“…Thus, 3-min preoxygenation is not sufficient for some patients. EtO 2 can be a useful indicator of whether adequate preoxygenation has been attained or whether leakage is present (41,43).…”

Section: Discussionmentioning

confidence: 99%