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"Preoxygenation" OR "Pre-oxygenation" OR "Pre Oxygenation" OR "Pre-Ox" OR "Apnoeic Oxygenation" OR "Ap-Ox"

Shyama Sathianathan, Rafay Nasir, Shigang Wang, Allen R Kunselman, Akif Ündar
The purpose of this study was to evaluate the hemodynamic properties and microemboli capture associated with different VAVD vacuum levels and venous reservoir levels in a neonatal CPB circuit. Trials were conducted in 2 parallel circuits to compare the performance of Capiox Baby RX05 oxygenator with separate AF02 arterial filter to Capiox FX05 oxygenator with integrated arterial filter. Arterial cannula flow rate to the patient was held at 500mL/min and temperature maintained at 32°C while VAVD vacuum levels (0mmHg, -15mmHg, -30mmHg, -45mmHg, -60mmHg) and venous reservoir levels (50mL, 200mL) were evaluated in both oxygenators...
December 4, 2018: Artificial Organs
Christina George, Aditya Martin, Narjeet Meena Osahan, Dootika Liddle
Growth of any kind in the oropharynx poses a threat to the airway especially during anaesthesia. Being aware of the challenges and adequately equipped to handle the situation is the duty of the anesthesiologist. Methods and Material: An eight year old girl diagnosed case of multiple mucous cysts presented to the outpatient department for excision of a lower lip mucous cyst. So an ultrasound was done which revealed a large intramural mucous cyst. After a preanaesthetic checkup she was posted for the excision of the cyst...
October 2018: Journal of Indian Association of Pediatric Surgeons
G Homfray, A Palmer, H Grimsmo-Powney, A Appelboam, G Lloyd
BACKGROUND: The elderly are perceived as a high-risk group for procedural sedation. Concern exists regarding the safety of sedation of this patient group by emergency physicians, particularly when using propofol. METHODS: We analysed prospectively collected data on patients aged 75 yr or older undergoing sedation between October 2006 and March 2017 in the emergency department of a single centre. We used the World Society of Intravenous Anaesthesia International Sedation Task Force adverse event tool, stratifying identified adverse events according to consensus agreement...
December 2018: British Journal of Anaesthesia
Paulo N Martins, Timothy A Berendsen, Heidi Yeh, Bote G Bruinsma, Maria-Louisa Izamis, Sanna Op den Dries, Andrew R Gillooly, Robert Porte, Martin L Yarmush, Korkut Uygun, James F Markmann
BACKGROUND: DCD liver grafts are known to be predisposed to primary nonfunction and ischemic cholangiopathy. Many DCD grafts are discarded because of older donor age or long warm ischemia times. Thus, it is critical to improve the quality of DCD liver grafts. Here, we have tested whether an enriched oxygen carrier added to the preservation solution can prolong graft survival and reduce biliary damage. METHODS: We assessed the ATP content decay of mouse liver grafts after cold ischemia, warm ischemia, and combined warm+cold ischemia...
November 13, 2018: Transplantation
David Kotwinski, Laura Paton, Roger Langford
The delivery of oxygen is a key component of anaesthetic practice. High flow nasal oxygen therapy is a relatively new addition to more traditional means of oxygenation which provides heated and humidified flows of controlled oxygen/air mixes achieving rates of up to 120 litres/min. The physiological benefits include nasopharyngeal dead space washout, reduced work of breathing, alveolar recruitment, maintained mucociliary function and the ability to provide apnoeic oxygenation. This article considers the current evidence for high flow nasal oxygen therapy in perioperative anaesthetic care during pre-oxygenation and intubation, management of the difficult airway, oxygenation for shared airway surgery, extubation and postoperative support, obstetric and paediatric anaesthesia...
November 2, 2018: British Journal of Hospital Medicine
J Grensemann, M Simon, S Kluge
In acute respiratory insufficiency, oxygenation and/or ventilation support by mechanical ventilation is an integral part of intensive care and emergency medicine. Effective airway management is essential to prevent hypoxic complications during the securing of the airway. This includes for example the recognition of difficult airways and adequate pre-oxygenation. While the laryngeal tube can be used in the context of cardiopulmonary resuscitation in emergency medicine, endotracheal intubation is standard in intensive care medicine...
November 5, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
J C Schäuble, T Heidegger
Several national airway task forces have recently updated their recommendations for the management of the difficult airway in adults. Routinely responding to airway difficulties with an algorithm-based strategy is consistently supported. The focus is increasingly not on tools and devices but more on good planning, preparation and communication. In the case of anticipated airway difficulties the airway should be secured when the patient is awake with maintenance of spontaneous ventilation. Unaltered a flexible bronchoscopic intubation technique is advised as a standard of care in such patients...
October 2018: Der Anaesthesist
Rajesh Kesavan, Sindhu Balakrishnan, Sunil Rajan, Shyam S Purushothaman, Rekha Varghese, Lakshmi Kumar
Background: Apneic mass movement of oxygen by applying continuous positive airway pressure (CPAP) is possible only when the airway is kept patent which helps to reduce the rate of desaturation. Aims: The aim of this study was to check the efficiency of preoxygenation and apneic oxygenation by assessing the drop in partial pressure of arterial oxygen (PaO2 ) during apnea with and without keeping an oropharyngeal airway to maintain the patency of airway. Settings and Design: This prospective observational study was conducted at a tertiary care center...
July 2018: Anesthesia, Essays and Researches
Nesrin Ahu Aslan, Çağıl Vural, Ali Abbas Yılmaz, Zekeriyya Alanoğlu
Objective: We investigated the effects of four different anaesthesia induction protocols on the haemodynamic response to laryngoscopy and tracheal intubation during rapid-sequence induction (RSI) in systolic hypertensive patients. Methods: One hundred and twenty hypertensive adult patients (systolic pressure >140 mmHg and diastolic pressure <90 mmHg), classified according to the American Association of Anesthesiologists as Class II and III were randomized into four groups...
September 2018: Turkish Journal of Anaesthesiology and Reanimation
Elena Bignami, Francesco Saglietti, Alessandro Girombelli, Andrea Briolini, Tiziana Bove, Luigi Vetrugno
We conducted a systematic review of the literature to better understand whether preoxygenation in non-critically ill patients (i.e. elective surgery patients) should be recommended, as it lengthens safe apnea time (the time required to reach oxygen saturation < 90% in an apneic patient). Furthermore, we looked for the most efficient technique amongst those currently employed in clinical practice. We searched Scopus, CINAHL, the Cochrane Library, PubMed and MeSH using various combinations of the words "preoxygenation", "general anesthesia", "induction", "operating room" and "oxygen"...
September 15, 2018: Journal of Clinical Anesthesia
Xifan Wang, Charlotte I Evans, Douglas Natelson
A thin coating of gold oxide, metastable at room temperature, can be formed by placing gold in a strongly oxidizing environment such as an oxygen plasma. We report scanning photovoltage measurements of lithographically defined gold nanowires subsequent to oxygen plasma exposure. Photovoltages are detected during the first optical scan of the devices that are several times larger than those mapped on subsequent scans. The first-scan enhanced photovoltage correlates with a reduction of the electrical resistance of the nanostructure back to preoxygen-exposure levels...
October 10, 2018: Nano Letters
Nicolas Walpen, Maximilian P Lau, Annika Fiskal, Gordon J Getzinger, Stefan A Meyer, Taylor F Nelson, Mark A Lever, Martin H Schroth, Michael Sander
Peat particulate organic matter (POM) is an important terminal electron acceptor for anaerobic respiration in northern peatlands provided that the electron-accepting capacity of POM is periodically restored by oxidation with O2 during peat oxygenation events. We employed push-pull tests with dissolved O2 as reactant to determine pseudo-first-order rate constants of O2 consumption ( kobs ) in anoxic peat soil of an unperturbed Swedish ombrotrophic bog. Dissolved O2 was rapidly consumed in anoxic peat with a mean kobs of 2...
October 2, 2018: Environmental Science & Technology
Armin Ahmed, Afzal Azim
Background: Endotracheal intubation in critically ill is a high-risk procedure requiring significant expertise in airway handling as well as understanding of pathophysiology of the disease process. Main body: Critically ill patients are prone for hypotension and hypoxemia in the immediate post-intubation phase due to blunting of compensatory sympathetic response. Preoxygenation without NIV is frequently suboptimal, as alveolar flooding cause loss of alveolar capillary interface in many of these patients...
2018: Journal of Intensive Care
Athanasios Chalkias, Fotios Pavlopoulos, Effie Papageorgiou, Christos Tountas, Artemis Anania, Maria Panteli, Apostolos Beloukas, Theodoros Xanthos
BACKGROUND: Cardiogenic shock is a life-threatening condition and patients might require rapid sequence induction (RSI) and mechanical ventilation. In this study, we evaluated a new RSI/mechanical ventilation protocol in patients with acute myocardial infarction complicated by cardiogenic shock. METHODS: We included consecutive adult patients who were transferred to the emergency department. The RSI protocol included 5 phases: preoxygenation, pretreatment, induction/paralysis, intubation, and mechanical ventilation (PPIIM)...
August 2018: Canadian Journal of Cardiology
Jeffrey J Cies, Wayne S Moore, Nadji Giliam, Tracy Low, Adela Enache, Arun Chopra
OBJECTIVES: To determine the oxygenator impact on alterations of ceftaroline in a contemporary neonatal/pediatric (1/4-inch) and adolescent/adult (3/8-inch) extracorporeal membrane oxygenation circuit including the Quadrox-i oxygenator (Maquet, Wayne, NJ). DESIGN: Quarter-inch and 3/8-inch, simulated closed-loop extracorporeal membrane oxygenation circuits were prepared with a Quadrox-i pediatric and Quadrox-i adult oxygenator and blood primed. Additionally, 1/4-inch and 3/8-inch circuits were also prepared without an oxygenator in series...
July 25, 2018: Pediatric Critical Care Medicine
Derek J Brown, Jessica Carmichael, Stephen M Carroll, Michael D April
BACKGROUND: Simultaneous use of nasal cannula (NC) with noninvasive positive pressure ventilation (NIPPV) may help streamline the transition from preoxygenation to intubation with apneic oxygenation in patients with deteriorating respiratory status, but may also compromise preoxygenation by impairing NIPPV mask seal. OBJECTIVES: To demonstrate that end-tidal oxygen (EtO2 ) after NIPPV with NC is noninferior to that of NIPPV without NC. METHODS: We conducted a randomized cross-over noninferiority study using healthy volunteers...
October 2018: Journal of Emergency Medicine
Carolyn S Sivco, Verghese T Cherian
The bag-valve-mask or the manual resuscitation bag is life-saving equipment. This article explains its construction, functioning, and limitations. This article also attempts to clarify some common misconceptions such as whether a resuscitation bag can be used to preoxygenate or provide continuous positive airway pressure or positive end-expiratory pressure and the highest percentage of oxygen that it can deliver.
July 20, 2018: A&A practice
Verna M Aykanat, Desmond P McGlade
This case demonstrates a novel preoxygenation technique in a patient with difficult access to the airway after a traumatic facial injury. To find a solution, a fusion of oxygenation equipment was trialed by altering and combining a tracheostomy mask and the tubing of an Optiflow circuit from which the nasal cannula component had been removed. This novel combination delivered high-flow humidified oxygen (60 L/min) orally, avoided further facial injury, and was well tolerated by the patient. Effective preoxygenation was confirmed by arterial gas measurements...
July 16, 2018: A&A practice
I Ng, R Krieser, P Mezzavia, K Lee, C Tseng, Nwr Douglas, R Segal
This study explored the use of high-flow nasal oxygen (HFNO) in both pre-oxygenation and apnoeic oxygenation in adults who were intubated following a non-rapid sequence induction. Fifty patients were randomised to receive pre-oxygenation via a standard facemask or the Transnasal Humidified Rapid-Insufflation Ventilatory Exchange (THRIVE) device. After five minutes of pre-oxygenation, induction and muscle relaxant agents were given. While waiting for complete paralysis, patients in the standard facemask group received bag-mask ventilation (BMV), whereas patients in the HFNO group received apnoeic oxygenation via the THRIVE device...
July 2018: Anaesthesia and Intensive Care
C Eichelsbacher, H Ilper, R Noppens, J Hinkelbein, T Loop
BACKGROUND: Induction of general anesthesia in patients with risk for aspiration needs special considerations to avoid the incidence and severity of complications. Since no evidence-based guidelines support the challenge for anesthesiologists various practical recommendations exist in clinical practice for rapid sequence induction and intubation (RSI). The aim of this systematic review is, to summarize the evidence and recommend a decision making process. MATERIAL AND METHODS: Multilevel RAND-delphi-method (RAND: Research and Development) combined with systematic literature research, individual assessment and evaluation, consensus conferences and final common sequence...
August 2018: Der Anaesthesist
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