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Apnoeic oxygenation

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https://www.readbyqxmd.com/read/29720758/ultra-modified-rapid-sequence-induction-with-transnasal-humidified-rapid-insufflation-ventilatory-exchange-challenging-convention
#1
Ketan Sakharam Kulkarni, Nandini Dave, Shriyam Saran, Madhu Garasia, Sandesh Parelkar
During positive pressure ventilation, gastric inflation and subsequent pulmonary aspiration can occur. Rapid sequence induction (RSI) technique is an age-old formula to prevent this. We adopted a novel approach of RSI for patients with high risk of aspiration and evaluated it further in patients undergoing laparoscopic surgeries. We believe that, in patients with risk of gastric insufflation and pulmonary aspiration, transnasal humidified rapid-insufflation ventilatory exchange can be useful in facilitating pre- and apnoeic oxygenation till tracheal isolation is achieved...
April 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29643554/effectiveness-of-transnasal-humidified-rapid-insufflation-ventilatory-exchange-versus-traditional-preoxygenation-followed-by-apnoeic-oxygenation-in-delaying-desaturation-during-apnoea-a-preliminary-study
#2
Sunil Rajan, Nandhini Joseph, Pulak Tosh, Dilesh Kadapamannil, Jerry Paul, Lakshmi Kumar
Background and Aims: Transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) during apnoea has shown to delay desaturation. The primary objective was to compare time to desaturate to <90% during apnoea with THRIVE versus traditional preoxygenation followed by apnoeic oxygenation. Methods: This prospective, randomised, single-blinded study was conducted in 10 adult patients presenting for direct laryngoscopy under general anaesthesia without endotracheal intubation...
March 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29484172/apnoeic-oxygenation-by-nasal-cannula-during-airway-management-in-children-undergoing-general-anaesthesia-a-pilot-randomised-controlled-trial
#3
Lafi Olayan, Abdulaleem Alatassi, Jaimin Patel, Sherran Milton
Background: Airway management is a core clinical skill in anaesthesia. Pre-oxygenation prior to induction of anaesthesia is a standard practice to prevent desaturation. Apnoeic oxygenation in adults is effective and prolongs the time to desaturation. The effectiveness of apnoeic oxygenation in the adult is well documented; however, evidence in the paediatric is lacking. Therefore, the aim of this study was to investigate the effectiveness of apnoeic oxygenation during airway management in children...
2018: Perioperative Medicine
https://www.readbyqxmd.com/read/29397127/high-flow-nasal-oxygen-therapy-in-intensive-care-and-anaesthesia
#4
REVIEW
T Renda, A Corrado, G Iskandar, G Pelaia, K Abdalla, P Navalesi
Oxygen therapy is first-line treatment for hypoxaemic acute respiratory failure (ARF). High-flow nasal oxygen therapy (HFNO) represents an alternative to conventional oxygen therapy. HFNO provides humidified, titrated oxygen therapy matching or even exceeding the patients' inspiratory demand. The application of HFNO is becoming widespread in Intensive Care Units (ICUs), favoured by increasing evidence based on numerous studies supporting its efficacy. The mechanisms of action and physiological effects of HFNO are not yet fully understood...
January 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29361254/high-flow-humidified-nasal-oxygen-in-pregnant-women
#5
REVIEW
Pcf Tan, A T Dennis
Failed airway management in the obstetric patient undergoing general anaesthesia is associated with major sequelae for the mother and/or fetus. Effective and adequate pre-oxygenation is an important safety strategy and a recommendation in all current major airway guidelines. Pre-oxygenation practice in the obstetric population may be suboptimal based on current literature. Recently, clinical applications for high flow nasal oxygen, also known as transnasal humidified rapid insufflation ventilatory exchange or THRIVE, are expanding in the non-obstetric population and may have theoretical benefits if used for pre-oxygenation and apnoeic oxygenation in the obstetric population...
January 2018: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29217855/effect-of-nasal-oxygen-supplementation-during-apnoea-of-intubation-on-arterial-oxygen-levels-a-prospective-randomised-controlled-trial
#6
Nishant Sahay, Shalini Sharma, Umesh K Bhadani, Chandni Sinha, Amarjeet Kumar, Alok Ranjan
Background and Aims: Apnoeic oxygenation during laryngoscopy has been emphasised in recent recommendations for airway management. We aimed to compare the effect of nasal oxygen supplementation on time for pulse oximeter oxygen saturation (SpO2 ) to fall from 100% to 92% (desaturation safety time), to assess the arterial oxygen partial pressures (PaO2 ) with and without nasal oxygen supplementation and the time for SpO2 to recover from 92% to 100% after initiation of ventilation. Methods: This is a prospective randomised placebo-controlled trial involving sixty patients, where nasal oxygen supplementation given at 10 L/min during apnoea of laryngoscopy in one group of patients (Group O2 ) was compared to no oxygen supplementation in other group (Group NoO2 )...
November 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29059825/enhanced-detection-of-sleep-apnoea-using-heart-rate-respiration-effort-and-oxygen-saturation-derived-from-a-photoplethysmography-sensor
#7
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
#8
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
#9
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...
September 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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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