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Apnoeic oxygenation

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https://www.readbyqxmd.com/read/29059825/enhanced-detection-of-sleep-apnoea-using-heart-rate-respiration-effort-and-oxygen-saturation-derived-from-a-photoplethysmography-sensor
#1
Madhuka Jayawardhana, Philip de Chazal
This paper presents a study on identifying sleep apnoea using the photoplethysmography (PPG) measurements, which is obtained from the SpO2 sensor. Using a database of polysomnogram (PSG) records of 52 patients, the heart rate and breathing effort information was derived from the PPG measurements and then features are extracted and processed by a classifier to detect one-minute epochs of sleep apnoea. The ground truth labels for the epochs were determined by trained technicians using the full PSG signal. Pulse oximetry (SpO2) measurements from the same sensor are also used in the classification process for comparison and in combination with the PPG results...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/29047136/apnoeic-oxygenation-with-high-flow-nasal-oxygen-for-laryngeal-surgery-a-case-series
#2
C Lyons, M Callaghan
Surgery under apnoeic conditions with the use of high-flow nasal oxygen is novel. Between November 2016 and May 2017, 28 patients underwent tubeless laryngeal or tracheal surgery under apnoeic conditions with high-flow nasal oxygen as the sole method of gas exchange. Patients received total intravenous anaesthesia and neuromuscular blocking agents for the duration of their surgery. The median (IQR [range]) apnoea time was 19 (15-24 [9-37]) min. Four patients experienced an episode of oxygen desaturation to a value between 85% and 90%, lasting less than 2 min in each case...
November 2017: Anaesthesia
https://www.readbyqxmd.com/read/28927811/postinduction-apnoea-in-dogs-premedicated-with-acepromazine-or-dexmedetomidine-and-anaesthetized-with-alfaxalone-or-propofol
#3
Sarah E Bigby, Thierry Beths, Sébastien Bauquier, Jennifer E Carter
OBJECTIVE: To compare incidence and duration of postinduction apnoea in dogs after premedication with methadone and acepromazine (MA) or methadone and dexmedetomidine (MD) followed by induction with propofol (P) or alfaxalone (A). STUDY DESIGN: Prospective, randomized clinical trial. ANIMALS: A total of 32 American Society of Anesthesiologists class I dogs (15 females, 17 males), aged between 4 months and 4 years, weighing between 3 and 46 kg...
March 2, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28912057/apnoeic-oxygenation-during-intubation-in-the-intensive-care-unit-a-systematic-review-and-meta-analysis
#4
REVIEW
Matthew J Binks, Rhys S Holyoak, Thomas M Melhuish, Ruan Vlok, Anthony Hodge, Thomas Ryan, Leigh D White
Hypoxaemia increases the risk of cardiac arrest and mortality during intubation. The reduced physiological reserve and reduced efficacy of pre-oxygenation in intensive care patients makes their intubation particularly dangerous. Apnoeic oxygenation is a promising means of preventing hypoxaemia in this setting. We sought to ascertain whether apnoeic oxygenation reduces the incidence of hypoxaemia when used during endotracheal intubation in the intensive care unit (ICU). A systematic review of five databases for all relevant studies published up to November 2016 was performed...
November 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/28891839/the-relative-effects-of-dexmedetomidine-and-propofol-on-cerebral-blood-flow-velocity-and-regional-brain-oxygenation-a-randomised-noninferiority-trial
#5
Ehab Farag, Michael Kot, Attila Podolyak, Maged Argalious, Milind Deogaonkar, Edward J Mascha, Zekun Xu, Irene Katzan, Zeyd Ebrahim
BACKGROUND: Dexmedetomidine constricts cerebral blood vessels without a concomitant reduction in cerebral metabolic oxygen consumption. Its safety as a sedative in patients with neurological diseases thus remains uncertain. OBJECTIVE: Our primary objective was to test the hypothesis that dexmedetomidine is noninferior to propofol as regards cerebral blood flow (CBF) velocity and brain oxygenation. DESIGN: Unblinded randomised trial. SETTING: Cleveland Clinic Hospital, Cleveland, from November 2010 to July 2013...
November 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28759652/sleep-apnoea-is-common-in-severe-peripheral-arterial-disease
#6
Nadjib Schahab, Sarah Sudan, Christian Schaefer, Vedat Tiyerili, Martin Steinmetz, Georg Nickenig, Dirk Skowasch, Carmen Pizarro
BACKGROUND: Atherosclerotic conditions have been demonstrated to be associated with sleep- disordered breathing (SDB). Peripheral arterial disease (PAD) represents severe atherosclerosis with a high mortality. In early stages of PAD a substantial prevalence of sleep apnoea has already been shown. Here, we sought to determine the frequency of undiagnosed sleep apnoea in a homogeneous group of advanced PAD patients undergoing percutaneous revascularization. METHODS: 59 consecutive patients (mean age: 71...
2017: PloS One
https://www.readbyqxmd.com/read/28684195/apneic-oxygenation-during-intubation-in-the-emergency-department-and-during-retrieval-a-systematic-review-and-meta-analysis
#7
REVIEW
Matthew J Binks, Rhys S Holyoak, Thomas M Melhuish, Ruan Vlok, Elyse Bond, Leigh D White
BACKGROUND: Hypoxemia increases the risk of intubation markedly. Such concerns are multiplied in the emergency department (ED) and during retrieval where patients may be unstable, preparation or preoxygenation time limited and the environment uncontrolled. Apneic oxygenation is a promising means of preventing hypoxemia in this setting. AIM: To test the hypothesis that apnoeic oxygenation reduces the incidence of hypoxemia during endotracheal intubation in the ED and during retrieval...
October 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28584350/a-randomised-comparative-study-of-miller-laryngoscope-blade-versus-oxiport-%C3%A2-miller-laryngoscope-blade-for-neonatal-and-infant-intubations
#8
Raylene Dias, Nandini Dave, Rachana Chhabria, Harick Shah, Madhu Garasia
BACKGROUND AND AIMS: Neonates and infants are prone to oxygen desaturation during the induction of general anaesthesia. Pharyngeal oxygen insufflation has been shown to delay the onset of desaturation and hypoxaemia during apnoea. We tested the hypothesis that deep laryngeal oxygenation with Oxiport(®) Miller blade would delay the onset of desaturation compared to laryngoscopy without supplemental oxygen (Miller blade). METHODS: One hundred neonates and infants undergoing general anaesthesia with endotracheal intubation for surgery were recruited and randomly assigned to one of the two groups: Miller or Oxiport group (laryngoscopy performed with Miller or Oxiport(®) blade, respectively)...
May 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28552071/vitamin-d-levels-in-middle-aged-patients-with-obstructive-sleep-apnoea-syndrome
#9
K Archontogeorgis, E Nena, N Papanas, A Zissimopoulos, A Voulgaris, M Xanthoudaki, V Manolopoulos, M Froudarakis, P Steiropoulos
BACKGROUND: Vitamin D (Vit D) insufficiency has been implicated in the pathophysiology of numerous diseases. Obstructive sleep apnoea syndrome (OSAS), a disorder associated with increased cardiovascular and cerebrovascular morbidity, has been associated with lowered Vit D levels, but reports are inconclusive. AIM: To evaluate the association between serum 25-hydroxyvitamin D [25(OH)D], a marker of Vit D status, and anthropometric and sleep characteristics of OSAS patients and to compare those levels between OSAS patients and non-apnoeic controls...
May 28, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28403407/apnoeic-oxygenation-in-adults-under-general-anaesthesia-using-transnasal-humidified-rapid-insufflation-ventilatory-exchange-thrive-a-physiological-study
#10
I-M Gustafsson, Å Lodenius, J Tunelli, J Ullman, M Jonsson Fagerlund
Background.: Apnoeic oxygenation during anaesthesia has traditionally been limited by the rapid increase in carbon dioxide and subsequent decrease in pH. Using a Transnasal Humidified Rapid-Insufflation Ventilatory Exchange (THRIVE) technique a slower increase in carbon dioxide than earlier studies was seen. Notably, apnoeic oxygenation using THRIVE has not been systematically evaluated with arterial blood gases or in patients undergoing laryngeal surgery. The primary aim of this study was to characterize changes in arterial P O 2 , P CO 2 and pH during apnoeic oxygenation using THRIVE under general anaesthesia...
April 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28126503/-pathophysiology-of-obstructive-sleep-apnea-syndrome-and-its-cardiometabolic-consequences
#11
REVIEW
Marie Destors, Renaud Tamisier, Louis-Marie Galerneau, Patrick Lévy, Jean-Louis Pepin
Obstructive sleep apnoea syndrome (OSAS) is characterized by recurrent partial or complete pharyngeal collapses during sleep. The pathophysiology of OSAS is complex and multifactorial. Factors influencing upper airway patency include a reduction in upper airway dimensions that can result from both anatomical and functional alterations (obesity, fluid shift or maxillo-facial structural changes), and increased pharyngeal collapsibility owing to reduced neuromuscular compensation and lack of the pharyngeal protective reflex during sleep...
April 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28100527/transnasal-humidified-rapid-insufflation-ventilatory-exchange-thrive-in-children-a-randomized-controlled-trial
#12
S Humphreys, P Lee-Archer, G Reyne, D Long, T Williams, A Schibler
BACKGROUND: Transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) was introduced to adult anaesthesia to improve the safety of airway management during apnoea before intubation. The objective of our study was to determine whether THRIVE safely prolongs apnoeic oxygenation in children. METHODS: This was a randomized controlled trial in 48 healthy children, with normal airways and cardiorespiratory function, in age groups 0-6 and 7-24 months, 2-5 and 6-10 yr old, presenting for elective surgery or imaging under general anaesthesia...
February 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28100516/transnasal-humidified-rapid-insufflation-ventilatory-exchange-thrive-in-children-a-step-forward-in-apnoeic-oxygenation-paradigm-shift-in-ventilation-or-both
#13
EDITORIAL
N Jagannathan, N Burjek
No abstract text is available yet for this article.
February 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28072931/apnoeic-oxygenation-during-intubation-a-systematic-review-and-meta-analysis
#14
REVIEW
L D White, T M Melhuish, L K White, L A Wallace
Apnoeic oxygenation during intubation is used to prevent desaturation during intubation. The aim of this review was to assess whether apnoeic oxygenation during endotracheal intubation reduced the incidence of hypoxaemia. Five major databases were systematically searched for all relevant studies published up to May 2016. All study designs with a control group and a group receiving apnoeic oxygenation were included in this review. These studies were then assessed for level of evidence and risk of bias. The data were then analysed using a meta-analysis...
January 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28003691/all-india-difficult-airway-association-2016-guidelines-for-the-management-of-unanticipated-difficult-tracheal-intubation-in-obstetrics
#15
Venkateswaran Ramkumar, Ekambaram Dinesh, Sumalatha Radhakrishna Shetty, Amit Shah, Pankaj Kundra, Sabyasachi Das, Sheila Nainan Myatra, Syed Moied Ahmed, Jigeeshu Vasishtha Divatia, Apeksh Patwa, Rakesh Garg, Ubaradka S Raveendra, Jeson Rajan Doctor, Dilip K Pawar, Singaravelu Ramesh
The various physiological changes in pregnancy make the parturient vulnerable for early and rapid desaturation. Severe hypoxaemia during intubation can potentially compromise two lives (mother and foetus). Thus tracheal intubation in the pregnant patient poses unique challenges, and necessitates meticulous planning, ready availability of equipment and expertise to ensure maternal and foetal safety. The All India Difficult Airway Association (AIDAA) proposes a stepwise plan for the safe management of the airway in obstetric patients...
December 2016: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/27730283/apnoeic-oxygenation-via-high-flow-nasal-cannula-oxygen-combined-with-non-invasive-ventilation-preoxygenation-for-intubation-in-hypoxaemic-patients-in-the-intensive-care-unit-the-single-centre-blinded-randomised-controlled-optiniv-trial
#16
RANDOMIZED CONTROLLED TRIAL
Samir Jaber, Marion Monnin, Mehdi Girard, Matthieu Conseil, Moussa Cisse, Julie Carr, Martin Mahul, Jean Marc Delay, Fouad Belafia, Gérald Chanques, Nicolas Molinari, Audrey De Jong
PURPOSE: High-flow nasal cannula oxygen (HFNC) has the potential to provide apnoeic oxygenation. We decided to assess in a proof-of-concept study whether the addition of HFNC to non-invasive ventilation (NIV) could reduce oxygen desaturation during intubation, compared with NIV alone for preoxygenation, in severely hypoxaemic intensive care unit (ICU) patients with respiratory failure. METHODS: We conducted a randomised, controlled, single-centre trial with assessor-blinded outcome assessment in patients admitted to the ICU...
December 2016: Intensive Care Medicine
https://www.readbyqxmd.com/read/27625198/recent-advances-in-the-diagnosis-and-management-of-obstructive-sleep-apnea
#17
REVIEW
Andrea Vianello, Valeria Bisogni, Claudia Rinaldo, Federico Gallan, Giuseppe Maiolino, Fausto Braccioni, Luca Guarda-Nardini, Beatrice Molena, Gian P Rossi, Rosario Marchese-Ragona
Affecting a large number of middle-aged, frequently overweight subjects, obstructive sleep apnea (OSA) is the most common sleep related breathing disorder. Partial or complete upper airway (UA) collapse during sleep causing repeated apneic episodes, which is the leading pathophysiological mechanism underlying the disorder, results in arterial oxygen desaturation and recurrent arousals from sleep to re-establish airway patency. Untreated OSA is commonly associated with a range of adverse consequences, including cardiovascular complications, such as arterial and/or pulmonary hypertension, arrhythmias, stroke, as well as diabetes mellitus and metabolic syndrome, and motor vehicle accidents...
December 2016: Minerva Medica
https://www.readbyqxmd.com/read/27519921/new-method-of-preoxygenation-for-orotracheal-intubation-in-patients-with-hypoxaemic-acute-respiratory-failure-in-the-intensive-care-unit-non-invasive-ventilation-combined-with-apnoeic-oxygenation-by-high-flow-nasal-oxygen-the-randomised-optiniv-study-protocol
#18
Samir Jaber, Nicolas Molinari, Audrey De Jong
INTRODUCTION: Tracheal intubation in the intensive care unit (ICU) is associated with severe life-threatening complications including severe hypoxaemia. Preoxygenation before intubation has been recommended in order to decrease such complications. Non-invasive ventilation (NIV)-assisted preoxygenation allows increased oxygen saturation during the intubation procedure, by applying a positive end-expiratory pressure (PEEP) to prevent alveolar derecruitment. However, the NIV mask has to be taken off after preoxygenation to allow the passage of the tube through the mouth...
August 12, 2016: BMJ Open
https://www.readbyqxmd.com/read/27440389/apnoeic-oxygenation-in-pregnancy-a-modelling-investigation
#19
A Pillai, M Chikhani, J G Hardman
Recent studies have shown that nasal oxygen delivery can prolong the time to desaturation during apnoea in the non-pregnant population. We investigated the benefits of apnoeic oxygenation during rapid sequence induction in the obstetric population using computational modelling. We used the Nottingham Physiology Simulator, and pre-oxygenated seven models of pregnancy for 3 min using Fi O2 1.0, before inducing apnoea. We found that increasing Fi O2 at the open glottis increased the time to desaturation, extending the time taken for Sa O2 to reach 40% from 4...
September 2016: Anaesthesia
https://www.readbyqxmd.com/read/27330180/bet-1-does-apnoeic-oxygenation-reduce-the-risk-of-desaturation-in-patients-requiring-endotracheal-intubation
#20
REVIEW
Gavin Denton, Laura Howard
A shortcut review of the literature was carried out to establish whether the use of apnoeic oxygenation technique during endotracheal intubation reduces the incidence of critical desaturation. Four trials were found to be directly relevant to the three-part question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. The clinical bottom line is that there is emerging evidence that the use of apnoeic oxygenation decreases the incidence of critical desaturation during endotracheal intubation...
July 2016: Emergency Medicine Journal: EMJ
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