Pharyngeal Oxygen Insufflation During AirTraq Laryngoscopy Slows Arterial Desaturation in Infants and Small Children

Windpassinger, Marita; Plattner, Olga; Gemeiner, Jana; Röder, Georg; Baumann, Arnulf; Zimmerman, Nicole M.; Sessler, Daniel I.

doi:10.1213/ane.0000000000001189

Cited by 43 publications

(31 citation statements)

References 10 publications

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“…Apnoeic oxygenation can be achieved with any device that enables administration of oxygen into the respiratory tract, including facemask, nasal cannula, nasopharyngeal catheter, supraglottic airway device, rigid bronchoscope, tracheal tube and front‐of‐neck catheter. Oxygen insufflation can also occur through channels located in direct and videolaryngoscopes .…”

Section: High‐flow Nasal Oxygen: Novel Mechanismsmentioning

confidence: 99%

“…Randomised controlled trials have shown a delayed time to oxygen desaturation with use of pharyngeal oxygen insufflation during elective traxcheal intubation . In one study, apnoeic oxygenation with high‐flow nasal oxygen at 1–2 l.kg.min −1 reduced the incidence of desaturation during intubation when compared with a control arm that did not receive any supplemental oxygen during apnoea .…”

Section: Paediatricsmentioning

confidence: 99%

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Uses and mechanisms of apnoeic oxygenation: a narrative review

Lyons

Callaghan

2019

Anaesthesia

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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.

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Section: High‐flow Nasal Oxygen: Novel Mechanismsmentioning

confidence: 99%

Section: Paediatricsmentioning

confidence: 99%

Uses and mechanisms of apnoeic oxygenation: a narrative review

Lyons

Callaghan

2019

Anaesthesia

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“…A recent case report demonstrated the utility of apneic oxygenation with low flow nasal cannula in a premature dysmorphic neonate who tolerated three intubation attempts without hypoxemia or bradycardia . Randomized trials in pediatric patients have shown that deep pharyngeal or laryngeal insufflation of oxygen via a laryngoscope results in slower rate of oxygen desaturation during laryngoscopy and extends apneic time before the onset of hypoxemia . In addition to the above techniques, the use of high flow, humidified oxygen via nasal cannula, as well as via simple nasal cannula at rates as low as 0.2 L/kg/min, has been shown to extend safe apneic times in pediatric patients and is reviewed by Humphreys and Schibler elsewhere in this issue.…”

Section: Oxygen Deliverymentioning

confidence: 99%

Emerging trends, techniques, and equipment for airway management in pediatric patients

Stein

Park

Kovatsis

2020

Pediatric Anesthesia

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Pediatric patients present unique anatomic and physiologic considerations in airway management, which impose significant physiologic limits on safe apnea time before the onset of hypoxemia and subsequent bradycardia. These issues are even more pronounced for the pediatric difficult airway. In the last decade, the development of pediatric sized supraglottic airways specifically designed for intubation, as well as advances in imaging technology such that current pediatric airway equipment now finally rival those for the adult population, has significantly expanded the pediatric anesthesiologist's tool kit for pediatric airway management. Equally important, techniques are increasingly implemented that maintain oxygen delivery to the lungs, safely extending the time available for pediatric airway management. This review will focus on emerging trends and techniques using existing tools to safely handle the pediatric airway including videolaryngoscopy, combination techniques for intubation, techniques for maintaining oxygenation during intubation, airway management in patients at risk for aspiration, and considerations in cannot intubate cannot oxygenate scenarios.

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“…Both prolong safe apnoea time. In paediatric practice, pharyngeal oxygen delivered via the laryngoscope is a well‐established technique, and this might also have utility in the adult population .…”

Section: Avoiding Hypoxiamentioning

confidence: 99%

Strategies for the prevention of airway complications – a narrative review

Cook

2017

Anaesthesia

132

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SummaryDespite being infrequent, complications of airway management remain an important contributor to morbidity and mortality during anaesthesia and care of the critically ill. Developments in the last three decades have made anaesthesia safer, and this has been mirrored in the equipment and techniques available for airway management. Modern technology including novel oxygenation modalities, widespread availability of capnography, second-generation supraglottic airway devices and videolaryngoscopy provide the tools to make airway management safer still. However, technology will only take safety so far, and non-technical aspects of airway management are critically important for communication and decision making during airway crises, acknowledging a 'cannot intubate, cannot oxygenate' situation and transitioning to emergency front of neck airway. Randomised controlled trials provide little useful information about safety in this setting, and data from registries and databases are likely to be of more value. This narrative review focuses on recent evidence in this area.

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Pharyngeal Oxygen Insufflation During AirTraq Laryngoscopy Slows Arterial Desaturation in Infants and Small Children

Abstract: Adding posterior pharyngeal oxygen insufflation to conventional preoxygenation prolonged the period of adequate oxygen saturation in infants and small children by an amount that is potentially clinically important.

Cited by 43 publications

References 10 publications

Uses and mechanisms of apnoeic oxygenation: a narrative review

Uses and mechanisms of apnoeic oxygenation: a narrative review

Emerging trends, techniques, and equipment for airway management in pediatric patients

Strategies for the prevention of airway complications – a narrative review

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