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Apneic oxygenation

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https://www.readbyqxmd.com/read/28099321/preoxygenation-physiologic-basis-benefits-and-potential-risks
#1
Usharani Nimmagadda, M Ramez Salem, George J Crystal
Preoxygenation before anesthetic induction and tracheal intubation is a widely accepted maneuver, designed to increase the body oxygen stores and thereby delay the onset of arterial hemoglobin desaturation during apnea. Because difficulties with ventilation and intubation are unpredictable, the need for preoxygenation is desirable in all patients. During emergence from anesthesia, residual effects of anesthetics and inadequate reversal of neuromuscular blockade can lead to hypoventilation, hypoxemia, and loss of airway patency...
February 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28066625/the-anesthesia-of-trachea-and-bronchus-surgery
#2
REVIEW
Zehra Hatipoglu, Mediha Turktan, Alper Avci
The trachea and bronchus surgery is generally performed due to stenosis, traumatic injury, foreign body and tumors. Preoperative evaluation and anesthesia management are very important issues because of higher mortality and morbidity rates. Patients may be asymptomatic, but airway difficulties, hypoxia, stridor, cough, hemoptysis are common conditions in these patient population. The collaboration between the surgeon and the anesthesiologist is very substantial and necessary. Anesthetic techniques include various applications such as one lung ventilation, fiberoptic intubation, jet ventilation, and apneic oxygenation, general anesthesia with or without neuromuscular blockade...
November 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28060323/a-model-to-simulate-clinically-relevant-hypoxia-in-humans
#3
Lars Eichhorn, Florian Kessler, Volker Böhnert, Felix Erdfelder, Anja Reckendorf, Rainer Meyer, Richard K Ellerkmann
In case of apnea, arterial partial pressure of oxygen (pO2) decreases, while partial pressure of carbon dioxide (pCO2) increases. To avoid damage to hypoxia sensitive organs such as the brain, compensatory circulatory mechanisms help to maintain an adequate oxygen supply. This is mainly achieved by increased cerebral blood flow. Intermittent hypoxia is a commonly seen phenomenon in patients with obstructive sleep apnea. Acute airway obstruction can also result in hypoxia and hypercapnia. Until now, no adequate model has been established to simulate these dynamics in humans...
December 22, 2016: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28050802/the-effectiveness-of-apneic-oxygenation-during-tracheal-intubation-in-various-clinical-settings-a-narrative-review
#4
David T Wong, Amanda J Yee, Siaw May Leong, Frances Chung
PURPOSE: During the process of tracheal intubation, patients are apneic or hypoventilating and are at risk of becoming hypoxemic. This risk is especially high in patients with acute or chronic respiratory failure and accompanying compromised respiratory reserve. To address this concern, apneic oxygenation can be administered during tracheal intubation to aid in maintaining arterial oxygen saturation. The objective of this narrative review is to examine the utilization of apneic oxygenation within the operating room, intensive care unit (ICU), emergency department, and pre-hospital settings and to determine its efficacy compared with controls...
January 3, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28008564/apneic-oxygenation-let-s-all-just-take-a-deep-breath
#5
EDITORIAL
Duane J Funk
No abstract text is available yet for this article.
December 22, 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/27906839/endothelin-contributes-to-the-blood-pressure-rise-triggered-by-hypoxia-in-severe-obstructive-sleep-apnea
#6
Christophe Janssen, Atul Pathak, Guido Grassi, Philippe van de Borne
BACKGROUND: Obstructive sleep apnea (OSA) is strongly correlated with an increased risk of systemic hypertension. However, the link between systemic hypertension and nocturnal apneas remains incompletely understood. Animal studies suggest an implication of the endothelin system. The aim of the present study is to determine if endogenous endothelin plays a role in the increase in blood pressure observed during hypoxic episodes in OSA patients, in addition to peripheral chemoreflex and neural sympathetic activation...
January 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/27894561/apneic-oxygenation-may-not-prevent-severe-hypoxemia-during-rapid-sequence-intubation-a-retrospective-helicopter-emergency-medical-service-study
#7
Sattha Riyapan, Jeffrey Lubin
OBJECTIVE: This study sought to determine the effectiveness of apneic oxygenation in preventing hypoxemia during prehospital rapid sequence intubation (RSI). METHODS: We performed a case-cohort study using a pre-existing database looking at intubation management by a single helicopter emergency medical service between July 2013 and June 2015. Apneic oxygenation using high-flow nasal cannula (15 L/min) was introduced to the standard RSI protocol in July 2014. Severe hypoxemia was defined as an incidence of oxygen saturation less than 90%...
November 2016: Air Medical Journal
https://www.readbyqxmd.com/read/27812496/reversible-exacerbation-of-obstructive-sleep-apnea-by-%C3%AE-1-adrenergic-blockade-with-tamsulosin-a-case-report
#8
Mark Moran
: Obstructive sleep apnea (OSA) is characterized by repeated involuntary closure of the pharyngeal airspace during sleep. Normal activity of the genioglossus (GG) muscle is important in maintaining airway patency, and inhibition of GG activity can contribute to airway closure. Neurons in the hypoglossal motor nucleus (HMN) regulate GG activity. Adrenergic tone is an important regulator of HMN neuronal excitability. In laboratory models α1-adrenergic antagonists inhibit HMN neurons and GG activity, suggesting that α1-adrenergic antagonism might adversely affect patients with OSA...
2016: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/27796837/emergency-ventilation-with-the-ventrain-%C3%A2-through-an-airway-exchange-catheter-in-a-porcine-model-of-complete-upper-airway-obstruction
#9
Michiel W P de Wolf, Reiner Gottschall, Niels P Preussler, Markus Paxian, Dietmar Enk
PURPOSE: During difficult airway management, oxygen insufflation through airway-exchange and intubating catheters (AEC/IC) can lead to life-threatening hyperinflation. Ventrain(®) was originally designed to facilitate emergency ventilation using active expiration through short, small-bore cannulas. Herein, we studied its efficacy (oxygenation and ventilation) and safety (avoidance of hyperinflation) in a long, small-bore AEC. METHODS: In six anesthetized pigs, the upper airway was obstructed, except for a 100 cm long, 3 mm internal diameter AEC...
January 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/27637969/apneic-oxygenation-and-intracranial-hemorrhage-where-the-rubber-meets-the-road
#10
Andrew Muck, Craig Sisson
No abstract text is available yet for this article.
October 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27615064/prognostic-importance-of-novel-oxygen-desaturation-metrics-in-patients-with-heart-failure-and-central-sleep-apnea
#11
Eiichi Watanabe, Ken Kiyono, Shojiro Matsui, Virend K Somers, Kan Sano, Junichiro Hayano, Tomohide Ichikawa, Mayumi Kawai, Masahide Harada, Yukio Ozaki
BACKGROUND: Sleep-disordered breathing, particularly central sleep apnea (CSA), is highly prevalent in heart failure (HF) and an independent prognostic marker. We assessed the hypothesis that an increased hypoxemic burden during sleep may have greater prognostic value than the frequency of apneic and hypopneic episodes. METHODS AND RESULTS: We prospectively conducted overnight cardiorespiratory polygraphy on consecutive HF patients referred to our hospital from 2008 to 2011...
September 9, 2016: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/27574999/neonatal-resuscitation-with-an-intact-cord-a-randomized-clinical-trial
#12
Anup Katheria, Debra Poeltler, Jayson Durham, Jane Steen, Wade Rich, Kathy Arnell, Mauricio Maldonado, Larry Cousins, Neil Finer
OBJECTIVE: To assess whether providing ventilation during delayed cord clamping (V-DCC) increases placental transfusion compared with delayed cord clamping alone (DCC only). STUDY DESIGN: Inborn premature infants (23(0/7)-31(6/7) weeks' gestational age) were randomized to receive at least 60 seconds of V-DCC (initial continuous positive airway pressure) with addition of positive pressure ventilation if needed) or without assisted ventilation (DCC only). For the DCC-only group, infants were dried and stimulated by gently rubbing the back if apneic...
August 26, 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/27546740/preoxygenation-and-apneic-oxygenation-using-transnasal-humidified-rapid-insufflation-ventilatory-exchange-for-emergency-intubation
#13
Alexander J Doyle, Daniel Stolady, Maryanne Mariyaselvam, Gayathri Wijewardena, Emma Gent, Mark Blunt, Peter Young
PURPOSE: Hypoxia is one of the leading causes of anesthesia-related injury. In response to the limitations of conventional preoxygenation, Transnasal Humidified Rapid-Insufflation Ventilatory Exchange (THRIVE) has been used as a method of providing both preoxygenation and apneic oxygenation during intubation. MATERIALS AND METHODS: In this prospective, observational study, THRIVE was introduced in a critical care unit (CCU), operating room (OR), and emergency department (ED) during emergency intubation of patients at high risk of hypoxia...
December 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27478966/assessment-of-adequacy-of-volume-resuscitation
#14
John H Boyd, Demetrios Sirounis
PURPOSE OF REVIEW: It has recently become evident that administration of intravenous fluids following initial resuscitation has a greater probability of producing tissue edema and hypoxemia than of increasing oxygen delivery. Therefore, it is essential to have a rational approach to assess the adequacy of volume resuscitation. Here we review passive leg raising (PLR) and respiratory variation in hemodynamics to assess fluid responsiveness. RECENT FINDINGS: The use of ultrasound enhances the clinician's ability to detect and predict fluid responsiveness, whereas enthusiasm for this modality must be tempered by recent evidence that it is only reliable in apneic patients...
October 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27454133/influence-of-apnea-induced-hypoxia-on-catecholamine-release-and-cardiovascular-dynamics
#15
L Eichhorn, F Erdfelder, F Kessler, R C Dolscheid-Pommerich, B Zur, U Hoffmann, R K Ellerkmann, R Meyer
Prolonged breath-hold causes complex compensatory mechanisms such as increase in blood pressure, redistribution of blood flow, and bradycardia. We tested whether apnea induces an elevation of catecholamine-concentrations in well-trained apneic divers.11 apneic divers performed maximal dry apnea in a horizontal position. Parameters measured during apnea included blood pressure, ECG, and central, in addition to peripheral hemoglobin oxygenation. Peripheral arterial hemoglobin oxygenation was detected by pulse oximetry, whereas peripheral (abdominal) and central (cerebral) tissue oxygenation was measured by Near Infrared Spectroscopy (NIRS)...
July 25, 2016: International Journal of Sports Medicine
https://www.readbyqxmd.com/read/27449231/apneic-events-a-proposed-new-target-for-respiratory-safety-pharmacology
#16
Dennis J Murphy
Current practice in respiratory safety pharmacology generally follows the regulatory guidance provided by the ICH document S7A and focuses on measures of pulmonary ventilation. What these measures do not account for is the ability of drugs to cause ventilatory instability or interruptions in ventilatory rhythm. Ventilatory instability can be identified by the presence of prolonged end-expiratory pauses or apneic periods. An apneic event has been defined as an apneic period of sufficient duration to cause hypoxia (i...
November 2016: Regulatory Toxicology and Pharmacology: RTP
https://www.readbyqxmd.com/read/27445853/inflammatory-role-of-ros-sensitive-amp-activated-protein-kinase-in-the-hypersensitivity-of-lung-vagal-c-fibers-induced-by-intermittent-hypoxia-in-rats
#17
Chang-Huan Yang, Yan-Jhih Shen, Ching Jung Lai, Yu Ru Kou
Obstructive sleep apnea (OSA), manifested by airway exposure to intermittent hypoxia (IH), is associated with excess reactive oxygen species (ROS) production in airways, airway inflammation, and hyperreactive airway diseases. The cause-effect relationship for these events remains unclear. We investigated the inflammatory role of ROS-sensitive AMP-activated protein kinase (AMPK) in IH-induced airway hypersensitivity mediated by lung vagal C fibers (LVCFs) in rats. Conscious rats were exposed to room air (RA) or IH with or without treatment with N-acetyl-L-cysteine (NAC, an antioxidant), Compound C (an AMPK inhibitor), ibuprofen (a cyclooxygenase inhibitor), or their vehicles...
2016: Frontiers in Physiology
https://www.readbyqxmd.com/read/27355526/randomized-trial-of-video-laryngoscopy-for-endotracheal-intubation-of-critically-ill-adults
#18
David R Janz, Matthew W Semler, Robert J Lentz, Daniel T Matthews, Tufik R Assad, Brett C Norman, Raj D Keriwala, Benjamin A Ferrell, Michael J Noto, Ciara M Shaver, Bradley W Richmond, Jeannette Zinggeler Berg, Todd W Rice
OBJECTIVE: To evaluate the effect of video laryngoscopy on the rate of endotracheal intubation on first laryngoscopy attempt among critically ill adults. DESIGN: A randomized, parallel-group, pragmatic trial of video compared with direct laryngoscopy for 150 adults undergoing endotracheal intubation by Pulmonary and Critical Care Medicine fellows. SETTING: Medical ICU in a tertiary, academic medical center. PATIENTS: Critically ill patients 18 years old or older...
November 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27342820/understanding-preoxygenation-and-apneic-oxygenation-during-intubation-in-the-critically-ill
#19
Jarrod M Mosier, Cameron D Hypes, John C Sakles
No abstract text is available yet for this article.
June 24, 2016: Intensive Care Medicine
https://www.readbyqxmd.com/read/27328978/activation-of-cannabinoid-cb1-receptors-suppresses-the-ros-induced-hypersensitivity-of-rat-vagal-lung-c-fiber-afferents
#20
Chou-Ming Yeh, Ting Ruan, Yu-Jung Lin, Tien-Huan Hsu
BACKGROUND: Reactive oxygen species (ROS), including H2O2, have been shown to induce hypersensitivity of vagal lung C-fibers (VLCFs) mainly through receptor potential ankyrin 1 (TRPA1) and P2X receptors. Cannabinoids (CBs) exert antinociceptive effects by binding to specific CB receptors, designated CB1 and CB2 (type 2) for type 1 and type 2, respectively. We investigated whether activation of CB receptors can suppress ROS-mediated VLCF hypersensitivity and, if so, what type(s) of CB receptors are involved...
October 2016: Pulmonary Pharmacology & Therapeutics
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