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Apnoeic oxygenation

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https://www.readbyqxmd.com/read/28126503/-pathophysiology-of-obstructive-sleep-apnea-syndrome-and-its-cardiometabolic-consequences
#1
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...
January 23, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28100527/transnasal-humidified-rapid-insufflation-ventilatory-exchange-thrive-in-children-a-randomized-controlled-trial
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
https://www.readbyqxmd.com/read/27165087/four-ways-to-ventilate-during-cardiopulmonary-resuscitation-in-a-porcine-model-a-randomized-study
#11
Benedict Kjærgaard, Egidijus Bavarskis, Sigridur Olga Magnusdottir, Charlotte Runge, Daiva Erentaite, Jes Sefland Vogt, Mette Dahl Bendtsen
BACKGROUND: The optimal method for out-of-hospital ventilation during cardiopulmonary rescue (CPR) is controversial. The aim of this study was to test different modes of ventilation during CPR for a prolonged period of 60 min. METHODS: Pigs were randomized to four groups after the induction of ventricular fibrillation, which was followed by one hour of mechanical cardiac compressions. The study comprised five pigs treated with free airways, five pigs treated with ventilators, six pigs treated with a constant oxygen flow into the tube, and six pigs treated with apnoeic oxygenation...
May 10, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/26917599/current-practice-of-rapid-sequence-induction-of-anaesthesia-in-the-uk-a-national-survey
#12
A Sajayan, J Wicker, N Ungureanu, C Mendonca, P K Kimani
BACKGROUND: The 'classical' technique of rapid sequence induction (RSI) of anaesthesia was described in 1970. With the introduction of new drugs and equipment in recent years, a wide variation in this technique has been used. The role of cricoid pressure is controversial because of the lack of scientific evidence. Moreover, gentle mask ventilation has been recommended in situations such as obesity and critically ill patients, to prevent hypoxaemia during the apnoeic period. In identifying multiple techniques, we conducted a national postal survey to establish the current practice of RSI in the UK...
September 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/26810494/association-between-continuous-positive-airway-pressure-and-circulating-omentin-levels-in-patients-with-obstructive-sleep-apnoea
#13
Firat Uygur, Hakan Tanrıverdi, Murat Can, Fatma Erboy, Bulent Altınsoy, Figen Atalay, Tacettin Ornek, Murat Damar, Furuzan Kokturk, Meltem Tor
PURPOSE: Inflammation and oxidative stress play important roles in the pathogenesis of obstructive sleep apnoea syndrome (OSAS). Omentin is expressed in visceral adipose tissue and is associated with the inflammatory response. The aim of this study was to assess the relationship between OSAS and omentin based on a comparison of its serum levels at baseline and after 3 months of continuous positive airway pressure (CPAP) therapy. METHODS: Ninety-six newly diagnosed OSAS patients and 31 non-apnoeic controls were enrolled in this study...
September 2016: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/26764895/ventilator-assisted-preoxygenation-protocol-for-combining-non-invasive-ventilation-and-apnoeic-oxygenation-using-a-portable-ventilator
#14
Steven Grant, Faisal Khan, Gerben Keijzers, Mark Shirran, Leo Marneros
OBJECTIVE: To describe a simple protocol for ventilator-assisted preoxygenation (VAPOX) prior to rapid sequence intubation in the ED using a Hamilton T1 ventilator in an effort to further reduce the incidence of transient and critical hypoxaemia. METHODS: Ventilator-assisted preoxygenation includes the following steps; preparation for rapid sequence intubation as per institutional protocols, including departmental checklists. Hamilton T1 ventilator is setup in non-invasive spontaneous/timed mode with settings as described...
February 2016: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/26738486/kinetics-of-arterial-carbon-dioxide-during-veno-venous-extracorporeal-membrane-oxygenation-support-in-an-apnoeic-porcine-model
#15
Pedro Vitale Mendes, Marcelo Park, Alexandre Toledo Maciel, Débora Prudêncio E Silva, Natalia Friedrich, Edzangela Vasconcelos Santos Barbosa, Adriana Sayuri Hirota, Guilherme Pinto Paula Schettino, Luciano Cesar Pontes Azevedo, Eduardo Leite Vieira Costa
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) is a technique widely used worldwide to improve gas exchange. Changes in ECMO settings affect both oxygen and carbon dioxide. The impact on oxygenation can be followed closely by continuous pulse oximeter. Conversely, carbon dioxide equilibrates much slower and is not usually monitored directly. METHODS: We investigated the time to stabilization of arterial carbon dioxide partial pressure (PaCO2) following step changes in ECMO settings in 5 apnoeic porcine models under veno-venous ECMO support with polymethylpentene membranes...
December 2016: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/26673585/the-role-of-an-ambient-pressure-oxygen-source-during-one-lung-ventilation-for-thoracoscopic-surgery
#16
J Pfitzner
Video-assisted thoracoscopic surgery is facilitated by prompt collapse of the non-ventilated ('operated') lung, and interrupted and impeded if there is a need for oxygen (O2) delivery by continuous positive airways pressure in order to manage hypoxaemia. It has been proposed that connecting an ambient pressure O2 source to the airway of the non-ventilated lung at the time one-lung ventilation is initiated and before the chest is opened will, by avoiding entrainment of ambient nitrogen, serve to facilitate lung collapse...
January 2016: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/26514055/optimising-the-management-of-bronchiolitis-in-infants
#17
REVIEW
Benjamiin McNaughten, Thomas W Bourke
Bronchiolitis shows a seasonal pattern with peak incidence occurring in the winter. Around 2-3% of children require admission to hospital. Admission rates are highest in infants less than three months old and those with underlying comorbidities. It typically affects children in the first year of life peaking between three and six months of age. Infants will have a coryzal prodrome lasting one to three days before developing a persistent cough. Fever and reduced feeding are common and very young infants may present with apnoeic episodes...
July 2015: Practitioner
https://www.readbyqxmd.com/read/26310407/prospective-observational-study-of-emergency-airway-management-in-the-critical-care-environment-of-a-tertiary-hospital-in-melbourne
#18
J F Dyett, M S Moser, A E Tobin
The objective of this study is to describe the population of patients receiving emergency airway management outside operating theatres at our institution, a tertiary referral centre in Melbourne. A registry of all patients receiving emergency airway management in the emergency department, ICU and on the wards as part of Medical Emergency Response teams' care, was prospectively collected. There were 128 adults and one paediatric patient requiring emergency airway management recruited to the study. Data for analysis included patient demographics, pre-oxygenation and apnoeic oxygenation, staff, drugs, details of laryngoscopic attempts, adjuncts, airway manoeuvres, complications sustained and method of confirmation of endotracheal tube placement...
September 2015: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/26058963/regional-spinal-epidural-caudal-versus-general-anaesthesia-in-preterm-infants-undergoing-inguinal-herniorrhaphy-in-early-infancy
#19
REVIEW
Lisa J Jones, Paul D Craven, Anil Lakkundi, Jann P Foster, Nadia Badawi
BACKGROUND: With improvements in neonatal intensive care, more preterm infants are surviving the neonatal period and presenting for surgery in early infancy. Inguinal hernia is the most common condition requiring early surgery, appearing in 38% of infants whose birth weight is between 751 grams and 1000 grams. Approximately 20% to 30% of otherwise healthy preterm infants having general anaesthesia for inguinal hernia surgery at a postmature age have at least one apnoeic episode within the postoperative period...
2015: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/26031444/the-effect-of-two-different-intra-operative-end-tidal-carbon-dioxide-tensions-on-apnoeic-duration-in-the-recovery-period-in-horses
#20
RANDOMIZED CONTROLLED TRIAL
Kate R Thompson, David Bardell
OBJECTIVE: To compare the effect of two different intraoperative end-tidal carbon dioxide tensions on apnoeic duration in the recovery period in horses. STUDY DESIGN: Prospective randomized clinical study. ANIMALS: Eighteen healthy client-owned adult horses (ASA I-II) admitted for elective surgery. Horses were of a median body mass of 595 (238-706) kg and a mean age of 9 ± 5 years. METHODS: A standardized anaesthetic protocol was used...
March 2016: Veterinary Anaesthesia and Analgesia
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