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Apneic oxygenation via nasal prongs at 10 L/min prevents hypoxemia during tracheal intubation for elective surgery

Chris Christodoulou, Pam Rohald, Tim Mullen, Tony Tran, Brett Hiebert, Trevor Lee, Sat Sharma
European Respiratory Journal 2013 42: P4923; DOI:
Chris Christodoulou
1Department of Anesthesia, University of Manitoba, Winnipeg, Canada
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Pam Rohald
1Department of Anesthesia, University of Manitoba, Winnipeg, Canada
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Tim Mullen
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Tony Tran
1Department of Anesthesia, University of Manitoba, Winnipeg, Canada
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Brett Hiebert
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Trevor Lee
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Sat Sharma
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Abstract

Introduction: Hypoxemia during airway management remains an important cause of morbidity and mortality. Oxygenation during intubation via nasal prongs may prevent critical desaturations (Anesthesiology 1988, J Korean Med Sci 1998). We evaluated the effectiveness of oxygen administration via nasal prongs during apneic period following induction of general anesthesia.

Methods: We conducted a randomized, controlled, double-blind study in patients without significant cardiac or respiratory disease undergoing elective surgery (age 18-65, ASA I-III). Patients randomly received oxygen via nasal prongs at 0, 5, or 10 L/min. Following preoxygenation, general anesthesia was induced. At 90 seconds after induction, nasal prongs were applied and oxygen was delivered according to the experimental group. At 4.5 minutes post-induction the patients were intubated.

Results: The study population consisted of 41 individuals, 14 in the 0 L group, 13 in the 5 L group, and 14 in the 10 L group. Significant difference occurred between the three treatments (p=0.030), across time (p=0.028), and the treatment effect across time (p=0.017). Mean PaO2 was higher in the 10 L group than the 5 L group (p=0.001) and 0 L group at 4 minutes (p=0.004).

Conclusion: Apneic oxygenation with 10 L/min compared to 5 L/min via nasal prongs demonstrated delay of desaturation and maintenance of higher PaO2 levels during elective intubation.

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  • Oxygen therapy
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Apneic oxygenation via nasal prongs at 10 L/min prevents hypoxemia during tracheal intubation for elective surgery
Chris Christodoulou, Pam Rohald, Tim Mullen, Tony Tran, Brett Hiebert, Trevor Lee, Sat Sharma
European Respiratory Journal Sep 2013, 42 (Suppl 57) P4923;

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Apneic oxygenation via nasal prongs at 10 L/min prevents hypoxemia during tracheal intubation for elective surgery
Chris Christodoulou, Pam Rohald, Tim Mullen, Tony Tran, Brett Hiebert, Trevor Lee, Sat Sharma
European Respiratory Journal Sep 2013, 42 (Suppl 57) P4923;
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