The Rate of Increase of Arterial Oxygen Saturation During Inhalation of Oxygen

Ws, Fowler; Jh, Comroe

doi:10.1097/00000441-194801000-00015

Cited by 6 publications

(8 citation statements)

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“…During standard pre‐oxygenation (tidal breathing of 100% oxygen through a facepiece connected to an appropriate breathing system for a number of minutes) early gains in stored oxygen are predominantly the result of nitrogen washout from the lungs accompanied by wash‐in of oxygen. This process is 80% complete at 1 min [11, 12] and takes approximately 7 min to reach ‘total denitrogenation’ following an exponential function [13]. The larger the functional residual capacity of the lungs, the greater the volume of oxygen stored.…”

Section: Discussionmentioning

confidence: 99%

A prospective, randomised controlled trial comparing the efficacy of pre‐oxygenation in the 20° head‐up vs supine position*

Lane

Saunders²,

Schofield³

et al. 2005

Anaesthesia

113

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We investigated whether positioning patients undergoing general anaesthesia for cholecystectomy in a 20°head-up position, as opposed to supine, improved the efficacy of 3 min of standard pre-oxygenation via a circle breathing system. Following pre-oxygenation, patients received a standard induction of anaesthesia and the apnoea time (from administration of rocuronium to the arterial oxygen saturation to fall to 95%) was recorded. Mean (95% CI) apnoea time was 386 (343-429) s in the 20°head-up position (n = 17) vs 283 (243-322) s in the supine position (n = 18; p = 0.002). Pre-oxygenation is significantly more efficacious and by inference more efficient in the 20°head-up position than in the supine position.

show abstract

Section: Discussionmentioning

confidence: 99%

A prospective, randomised controlled trial comparing the efficacy of pre‐oxygenation in the 20° head‐up vs supine position*

Lane

Saunders²,

Schofield³

et al. 2005

Anaesthesia

113

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show abstract

“…Pre‐oxygenation has been examined extensively and recommendations for its duration vary between 2 and 7 min [11, 12]. All forms of pre‐oxygenation rely on a technique that, among other factors, eliminates rebreathing [13].…”

Section: Discussionmentioning

confidence: 99%

Rapid sequence induction: a national survey of practice

Morris

Cook

2001

Anaesthesia

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We performed a national postal survey exploring anaesthetists' practice in rapid sequence induction. All respondents used pre‐oxygenation, although the technique employed, and its reliability, varied. Thiopental and succinylcholine, given after waiting for signs of loss of consciousness, were the most widely used drugs for rapid sequence induction. Propofol and rocuronium were used by more than a third of respondents, and most respondents (75%) also routinely administered an opioid. Cricoid pressure was used universally but the practice of its application varied widely. The commonest aids used if intubation was difficult were the gum elastic bougie, the long laryngoscope blade and the laryngeal mask. After failed intubation, approximately half of respondents would maintain the supine position. Failure to intubate at rapid sequence intubation had been seen by 45% of respondents but harm was uncommon. In contrast, 28% had seen regurgitation, which frequently led to considerable harm and to three deaths. In spite of this, practice of a failed intubation drill was uncommon (15%) and anaesthetic assistants were rarely known to practice application of cricoid pressure. Consultants were less likely than trainees to use rocuronium as a muscle relaxant, and more likely to choose morphine if administering an opioid. They were less likely to practice a failed intubation drill. Other aspects of practice varied little between grades. This survey suggests that many anaesthetists do not follow best practice when performing a rapid sequence induction.

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“…Feasibility however, goes beyond ‘acceptability’ and encompasses ‘achievability’. The anaesthetic literature records the variables that influence denitrogenation for a simple face‐mask technique, from choice of circuit and fresh gas flow [6], quality of seal [7] and timescale [8], this before ventilatory technique [9] or patient factors [10] are considered. If an end‐point for pre‐oxygenation is defined, such as an F eO 2 of 0.9 [11], as opposed to specifying a particular technique, ‘achievability’ may for certain patients have to encompass the use of specialised administration devices [12].…”

Section: Feasibility Of Pre‐oxygenationmentioning

confidence: 99%

Routine pre‐oxygenation – a new ‘minimum standard’ of care?

Bell¹

2004

Anaesthesia

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The Rate of Increase of Arterial Oxygen Saturation During Inhalation of Oxygen

Cited by 6 publications

References 0 publications

A prospective, randomised controlled trial comparing the efficacy of pre‐oxygenation in the 20° head‐up vs supine position*

A prospective, randomised controlled trial comparing the efficacy of pre‐oxygenation in the 20° head‐up vs supine position*

Rapid sequence induction: a national survey of practice

Routine pre‐oxygenation – a new ‘minimum standard’ of care?

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