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Apneic oxygenation

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https://www.readbyqxmd.com/read/29699900/apneic-oxygenation-reduces-hypoxemia-during-endotracheal-intubation-in-the-pediatric-emergency-department
#1
Adam A Vukovic, Holly R Hanson, Shelley L Murphy, Danielle Mercurio, Craig A Sheedy, Donald H Arnold
BACKGROUND: Apneic oxygenation (AO) has been evaluated in adult patients as a means of reducing hypoxemia during endotracheal intubation (ETI). While less studied in pediatric patients, its practice has been largely adopted. OBJECTIVE: Determine association between AO and hypoxemia in pediatric patients undergoing ETI. METHODS: Observational study at an urban, tertiary children's hospital emergency department. Pediatric patients undergoing ETI were examined during eras without (January 2011-June 2011) and with (August 2014-March 2017) apneic oxygenation...
April 18, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29687359/does-apneic-oxygenation-prevent-desaturation-during-emergency-airway-management-a-systematic-review-and-meta-analysis
#2
Edmund Tan, Osama Loubani, Nelofar Kureshi, Robert S Green
RéSUMé: OBJECTIF: L'oxygénation apnéique (OA) par lunettes nasales est une méthode de prévention de la désaturation en oxygène au cours des intubations en urgence. L'objectif de cette revue systématique était de déterminer l'efficacité de l'OA sur la prévention de la désaturation en oxygène au cours des intubations en urgence. SOURCE: Des recherches systématiques ont été effectuées dans trois bases de données électroniques (MEDLINE, EMBASE et CINAHL) pour identifier les études portant sur la prévention de la désaturation en oxygène au moyen de l'OA par lunettes nasales...
April 23, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29628590/comparison-of-arterial-oxygenation-and-acid-base-balance-with-the-use-of-transnasal-humidified-rapid-insufflation-ventilatory-exchange-versus-tidal-volume-breathing-with-continuous-positive-airway-pressure-for-preoxygenation-and-apneic-ventilation
#3
Nandhini Joseph, Sunil Rajan, Pulak Tosh, Dilesh Kadapamannil, Lakshmi Kumar
Background: Preoxygenation and apneic ventilation prolong apnea time without desaturation. Aims: The primary objective of this study is to compare arterial oxygenation during the periods of apnea following preoxygenation and apneic ventilation with tidal volume breathing for 3 min with continuous positive airway pressure (CPAP) versus with transnasal humidified rapid-insufflation ventilatory exchange (THRIVE). Settings and Designs: This prospective randomized study was conducted in 20 adult patients at a tertiary care institution...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29628587/effects-of-preoxygenation-with-tidal-volume-breathing-followed-by-apneic-oxygenation-with-and-without-continuous-positive-airway-pressure-on-duration-of-safe-apnea-time-and-arterial-blood-gases
#4
Sunil Rajan, Nandhini Joseph, Pulak Tosh, Jerry Paul, Lakshmi Kumar
Background: Application of continuous positive airway pressure (CPAP) helps to recruit collapsed areas of the lung, which improves the oxygen reserve. Aim of the Study: To compare the time to desaturate to 90% during apnea following preoxygenation and apneic ventilation with tidal volume breathing for 3 min with and without the application of CPAP. Settings and Design: This prospective randomized study was conducted in a tertiary care institution...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29560073/nasal-cannula-apneic-oxygenation-prevents-desaturation-during-endotracheal-intubation-an-integrative-literature-review
#5
REVIEW
Joshua M Gleason, Bill R Christian, Erik D Barton
Patients requiring emergency airway management may be at greater risk of acute hypoxemic events because of underlying lung pathology, high metabolic demands, insufficient respiratory drive, obesity, or the inability to protect their airway against aspiration. Emergency tracheal intubation is often required before complete information needed to assess the risk of procedural hypoxia is acquired (i.e., arterial blood gas level, hemoglobin value, or chest radiograph). During pre-oxygenation, administering high-flow nasal oxygen in addition to a non-rebreather face mask can significantly boost the effective inspired oxygen...
March 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29557323/apneic-oxygenation-provides-incremental-benefit-during-intubation-of-patients-in-the-emergency-medicine-and-critical-care-settings
#6
Daniel K Ting, Eddy S Lang
Clinical question Should I use apneic oxygenation when intubating patients in the emergency department to increase peri-intubation oxygen saturation and first-pass success? Article chosen Oliveira JE, Silva L, Cabrera D, Barrionuevo P, et al. Effectiveness of apneic oxygenation during intubation: a systematic review and meta-analysis. Ann Emerg Med 2017;70(4):483-94. OBJECTIVE: The purpose of this study was to synthesize and appraise the apneic oxygenation literature for its effect on peri-intubation outcomes...
March 20, 2018: CJEM
https://www.readbyqxmd.com/read/29544682/intermittent-hypoxia-suppression-of-growth-hormone-and-insulin-like-growth-factor-i-in-the-neonatal-rat-liver
#7
Charles Cai, Taimur Ahmad, Gloria B Valencia, Jacob V Aranda, Jiliu Xu, Kay D Beharry
OBJECTIVES: Extremely low gestational age neonates with chronic lung disease requiring oxygen therapy frequently experience fluctuations in arterial oxygen saturation or intermittent hypoxia (IH). These infants are at risk for multi-organ developmental delay, reduced growth, and short stature. The growth hormone (GH)/insulin-like growth factor-I (IGF-1) system, an important hormonal regulator of lipid and carbohydrate metabolism, promotes neonatal growth and development. We tested the hypothesis that increasing episodes of IH delay neonatal growth by influencing the GH/IGF-I axis...
March 8, 2018: Growth Hormone & IGF Research
https://www.readbyqxmd.com/read/29530653/implementation-of-a-clinical-bundle-to-reduce-out-of-hospital-peri-intubation-hypoxia
#8
Jeffrey L Jarvis, John Gonzales, Danny Johns, Lauren Sager
STUDY OBJECTIVE: Peri-intubation hypoxia is an important adverse event of out-of-hospital rapid sequence intubation. The aim of this project is to determine whether a clinical bundle encompassing positioning, apneic oxygenation, delayed sequence intubation, and goal-directed preoxygenation is associated with decreased peri-intubation hypoxia compared with standard out-of-hospital rapid sequence intubation. METHODS: We conducted a retrospective, before-after study using data from a suburban emergency medical services (EMS) system in central Texas...
March 9, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29503275/feasibility-of-helmet-delivered-continous-positive-airway-pressure-in-very-low-birthweight-infants
#9
LETTER
Almudena Alonso-Ojembarrena, Antonio Segado-Arenas, Isabel Benavente-Fernández, Simón Pedro Lubián-López
We describe our experience with helmet-delivered continuous positive airway pressure in five preterm newborns. We analyzed oxygen requirement, arterial oxygen saturation, respiratory rate, medium arterial pressure, heart rate, apneic spells and patient's comfort. The patients' vital signs or pain scale were not different before and after treatment.
February 15, 2018: Indian Pediatrics
https://www.readbyqxmd.com/read/29357505/chemoreflex-mediated-arrhythmia-during-apnea-at-5-050-m-in-low-but-not-high-altitude-natives
#10
Stephen A Busch, Hannah Davies, Sean van Diepen, Lydia L Simpson, Frances Sobierajski, Laurel Riske, Mike Stembridge, Philip N Ainslie, Christopher K Willie, Ryan Hoiland, Jonathan P Moore, Craig D Steinback
Peripheral chemoreflex mediated increases in both parasympathetic and sympathetic drive under chronic hypoxia may evoke bradyarrhythmias during apneic periods. We determined whether 1) voluntary apnea unmasks arrhythmia at low (344 m) and high (5,050 m) altitude, 2) high-altitude natives (Nepalese Sherpa) exhibit similar cardiovagal responses at altitude, and 3) bradyarrhythmias at altitude are partially chemoreflex mediated. Participants were grouped as Lowlanders ( n = 14; age = 27 ± 6 yr) and Nepalese Sherpa ( n = 8; age = 32 ± 11 yr)...
April 1, 2018: Journal of Applied Physiology
https://www.readbyqxmd.com/read/29351759/tracheal-intubation-in-critically-ill-patients-a-comprehensive-systematic-review-of-randomized-trials
#11
Luca Cabrini, Giovanni Landoni, Martina Baiardo Radaelli, Omar Saleh, Carmine D Votta, Evgeny Fominskiy, Alessandro Putzu, Cézar Daniel Snak de Souza, Massimo Antonelli, Rinaldo Bellomo, Paolo Pelosi, Alberto Zangrillo
BACKGROUND: We performed a systematic review of randomized controlled studies evaluating any drug, technique or device aimed at improving the success rate or safety of tracheal intubation in the critically ill. METHODS: We searched PubMed, BioMed Central, Embase and the Cochrane Central Register of Clinical Trials and references of retrieved articles. Finally, pertinent reviews were also scanned to detect further studies until May 2017. The following inclusion criteria were considered: tracheal intubation in adult critically ill patients; randomized controlled trial; study performed in Intensive Care Unit, Emergency Department or ordinary ward; and work published in the last 20 years...
January 20, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29208322/face-mask-leak-with-nasal-cannula-during-noninvasive-positive-pressure-ventilation-a-randomized-crossover-trial
#12
Derek J Brown, Stephen M Carroll, Michael D April
BACKGROUND: Nasal cannula can achieve apneic oxygenation during emergency intubation. However, pre-procedure nasal cannula placement may be difficult in patients undergoing non-invasive positive pressure ventilation (NPPV) prior to intubation. Our objective was to compare mask leak during NPPV with versus without simultaneous application of nasal cannula. We hypothesized mask leak would be no worse with concomitant use of nasal cannula (non-inferiority design). METHODS: We performed a randomized crossover non-inferiority study of healthy volunteers...
December 2, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29171300/tubeless-total-intravenous-anesthesia-spontaneous-ventilation-for-adult-suspension-microlaryngoscopy
#13
Mi Jin Yoo, Aaron M Joffe, Tanya K Meyer
INTRODUCTION: Maintaining spontaneous ventilation (SV) under total intravenous anesthesia (TIVA) without an endotracheal tube provides uninterrupted and unobstructed surgical access for suspension microlaryngoscopy (SML). This study describes the method and outcome of adults who underwent SML under tubeless TIVA-SV. METHODS: Retrospective review of adults who underwent SML between June 2014 and September 2016 using TIVA-SV without an endotracheal tube. RESULTS: Sixty-six cases in 36 patients were included with mean age of 50...
January 2018: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/29151335/comparison-of-tidal-volume-and-deep-breath-preoxygenation-techniquesundergoing-coronary-artery-bypass-graft-surgery-effects-of-hemodynamicresponse-and-arterial-oxygenation
#14
Zafer Taş, Tülay Hoşten, Alparslan Kuş, Sevim Cesur, Neşe Türkyılmaz, Ahmet Arıkan, Zeynep Mine Solak
Background/aim: Different techniques exist for the preoxygenation of patients that will be operated on under general anesthesia. Preoxygenation with the deep breath (DB) method may affect cardiovascular stability, which is crucial for coronary artery bypass graft (CABG) patients. In this study, we aimed to compare the effects of the 3 min TVB preoxygenation technique and 1 min 8DBs technique on hemodynamic response and arterial oxygenation in patients with normal ejection fraction that were scheduled for elective CABG surgery...
November 13, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/29095183/the-effect-of-apneic-oxygenation-on-reducing-hypoxemia-during-rapid-sequence-induction-and-intubation-in-the-acutely-ill-or-injured
#15
Autumn Riddell
Apneic oxygenation during intubation is the application of oxygen via a nasal cannula, which is left in place throughout laryngoscopy. The flow rate of oxygen is set to at least 15 L/min and theoretically reduces the risk of oxygen desaturation and hypoxemia during the procedure. Over the last 5 years, there have been several studies published on this topic with differing results. Despite conflicting results, use of apneic oxygenation is becoming more prevalent and is being implemented into standard operating procedures in some clinical settings...
October 2017: Advanced Emergency Nursing Journal
https://www.readbyqxmd.com/read/29095178/changing-the-emergency-department-s-practice-of-rapid-sequence-intubation-to-reduce-the-incidence-of-hypoxia
#16
Michael D Gooch, Eric Roberts
Rapid sequence intubation (RSI) is an advanced procedure performed by nurse practitioners in the emergency department (ED). Hypoxia is one of the most common complications associated with RSI, which may lead to serious sequela, including death. Hypoxia may result from medications that are given to facilitate the procedure or the underlying disease process. Without preventive measures, oxygen levels may fall rapidly when patients are no longer actively breathing. The incidence of RSI-induced hypoxia may be mitigated with proper education, preoxygenation, positioning, and the utilization of passive (apneic) oxygenation...
October 2017: Advanced Emergency Nursing Journal
https://www.readbyqxmd.com/read/29063722/a-quality-improvement-initiative-to-increase-the-safety-of-pediatric-emergency-airway-management
#17
Elliot Long, Domenic R Cincotta, Joanne Grindlay, Stefano Sabato, Emmanuelle Fauteux-Lamarre, David Beckerman, Terry Carroll, Nuala Quinn
BACKGROUND: Emergency airway management is commonly associated with life-threatening hypoxia and hypotension which may be preventable. AIMS: The aim of this quality improvement study was to reduce the frequency of intubation-related hypoxia and hypotension. METHODS: This prospective quality improvement study was conducted over 4 years in the Emergency Department of The Royal Children's Hospital, Melbourne, Australia. A preintervention cohort highlighted safety gaps and was used to design study interventions, including an emergency airway algorithm, standardized airway equipment, a preintubation checklist and equipment template, endtidal carbon dioxide monitoring, postintubation team debriefing, and multidisciplinary team training...
December 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29051828/intubation-following-high-dose-rocuronium-in-a-cat-with-protracted-laryngospasm
#18
Graeme M Doodnaught, Daniel Sj Pang
CASE SUMMARY: An 11-year-old spayed female domestic shorthair cat with a history of laryngospasm at induction of general anesthesia presented for dental evaluation and treatment. The cat was premedicated with hydromorphone (0.05 mg/kg) and alfaxalone (0.5 mg/kg) intravenously, pre-oxygenated for 5 mins (3 l/min, face mask) and anesthesia was induced with alfaxalone (to effect) intravenously. Lidocaine (0.1 ml, 2%) was applied topically to the arytenoid cartilages following loss of jaw tone...
July 2017: JFMS Open Reports
https://www.readbyqxmd.com/read/28915219/intrabronchial-catheter-resuscitation-for-respiratory-and-cardiorespiratory-arrest
#19
Jeffrey S Wolf, Andrea Hebert, Pablo Sanchez, Marniker Wijesinha, Scott Shapiro, Robert Morales, Aldo T Iacono
INTRODUCTION: We sought to determine whether intrabronchial oxygenation would provide adequate gas exchange during both anesthesia induced apneic and cardiopulmonary arrest and cardiac massage (CPR). METHODS: Ten pigs underwent general anesthesia with mechanical ventilation. Blood gases were measured in each animal at 4 min intervals for up to 28 min. An intrabronchial catheter (4 L/min O2) was inserted through an endotracheal tube after respirator cessation. Group A animals (6) were resuscitated with the catheter but without CPR...
September 14, 2017: Shock
https://www.readbyqxmd.com/read/28891821/heart-rate-variability-as-a-feeding-intervention-outcome-measure-in-the-preterm-infant
#20
Britt F Pados, Suzanne M Thoyre, George J Knafl, William Brant Nix
BACKGROUND: Feeding interventions for preterm infants aim to reduce the physiologic stress of feeding to promote growth. Heart rate variability (HRV) is a potential noninvasive measure of physiologic stress that may be useful for evaluating efficacy of feeding interventions. PURPOSE: To evaluate whether HRV is a sensitive measure of physiologic stress compared with standard physiologic outcomes in the context of a feeding intervention study. METHODS: This was a secondary analysis of a within-subjects, cross-over design study comparing usual care feeding with a gentle, coregulated (CoReg) feeding approach in 14 infants born less than 35 weeks' postmenstrual age...
October 2017: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
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