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Christopher Groombridge, Cheau Wern Chin, Bernard Hanrahan, Anna Holdgate
OBJECTIVES: Preoxygenation prior to intubation aims to increase the duration of safe apnea by causing denitrogenation of the functional residual capacity, replacing this volume with a reservoir of oxygen. In the operating room (OR) the criterion standard for preoxygenation is an anesthetic circuit and well-fitting face mask, which provide a high fractional inspired oxygen concentration (FiO2 ). Outside of the OR, various strategies exist to provide preoxygenation. The objective was to evaluate the effectiveness of commonly used preoxygenation strategies outside of the OR environment...
March 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Yashvi Wimalasena, Brian Burns, Cliff Reid, Sandra Ware, Karel Habig
STUDY OBJECTIVE: The Greater Sydney Area Helicopter Emergency Medical Service undertakes in excess of 2,500 physician/paramedic out-of-hospital and interhospital retrievals each year, of which 8% require intubation. Emergency anesthesia of critically ill patients is associated with complications, including hypoxia. In July 2011, the service introduced apneic oxygenation with nasal cannulae to its emergency anesthesia standard operating procedure to reduce rates of desaturation during rapid sequence intubation...
April 2015: Annals of Emergency Medicine
Romain Miguel-Montanes, David Hajage, Jonathan Messika, Fabrice Bertrand, Stéphane Gaudry, Cédric Rafat, Vincent Labbé, Nicolas Dufour, Sylvain Jean-Baptiste, Alexandre Bedet, Didier Dreyfuss, Jean-Damien Ricard
OBJECTIVES: Tracheal intubation of ICU patients is frequently associated with severe hypoxemia. Although noninvasive ventilation reduces desaturation during intubation of severely hypoxemic patients, it does not allow for per-procedure oxygenation and has not been evaluated in mild-to-moderate hypoxemic patients for whom high-flow nasal cannula oxygen may be an alternative. We sought to compare pre- and per-procedure oxygenation with either a nonrebreathing bag reservoir facemask or a high-flow nasal cannula oxygen during tracheal intubation of ICU patients...
March 2015: Critical Care Medicine
A Patel, S A R Nouraei
Emergency and difficult tracheal intubations are hazardous undertakings where successive laryngoscopy-hypoxaemia-re-oxygenation cycles can escalate to airway loss and the 'can't intubate, can't ventilate' scenario. Between 2013 and 2014, we extended the apnoea times of 25 patients with difficult airways who were undergoing general anaesthesia for hypopharyngeal or laryngotracheal surgery. This was achieved through continuous delivery of transnasal high-flow humidified oxygen, initially to provide pre-oxygenation, and continuing as post-oxygenation during intravenous induction of anaesthesia and neuromuscular blockade until a definitive airway was secured...
March 2015: Anaesthesia
Christopher Moran, Dharshi Karalapillai, Jai Darvall, Amar Nanuan
No abstract text is available yet for this article.
September 2014: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
Alexander Kolettas, Vasilis Grosomanidis, Vasilis Kolettas, Paul Zarogoulidis, Kosmas Tsakiridis, Nikolaos Katsikogiannis, Theodora Tsiouda, Ioanna Kiougioumtzi, Nikolaos Machairiotis, Georgios Drylis, Georgios Kesisis, Thomas Beleveslis, Konstantinos Zarogoulidis
Apnoeic oxygenation is an alternative technique of oxygenation which is recommended in the consecutive oxygen administration with varying flows (2-10 lt/min) through a catheter which is positioned over the keel of the trachea. Apnoeic oxygenation maintains for a significant period of time the oxygenation of blood in breathless conditions. This technique was first applied in 1947 by Draper, Whitehead, and Spencer and it was studied sporadically by other inventors too. However, the international literature shows few studies that have examined closely apnoeic oxygenation and its effects on Hemodynamic image and the respiratory system of the human body...
March 2014: Journal of Thoracic Disease
Scott D Weingart, Richard M Levitan
Patients requiring emergency airway management are at great risk of hypoxemic hypoxia because of primary lung pathology, high metabolic demands, anemia, insufficient respiratory drive, and inability to protect their airway against aspiration. Tracheal intubation is often required before the complete information needed to assess the risk of periprocedural hypoxia is acquired, such as an arterial blood gas level, hemoglobin value, or even a chest radiograph. This article reviews preoxygenation and peri-intubation oxygenation techniques to minimize the risk of critical hypoxia and introduces a risk-stratification approach to emergency tracheal intubation...
March 2012: Annals of Emergency Medicine
Scott D Weingart
BACKGROUND: The goal of preoxygenation is to provide us with a safe buffer of time before desaturation during Emergency Department intubation. For many intubations, the application of an oxygen mask is sufficient to provide us with ample time to safely intubate our patients. However, some patients are unable to achieve adequate saturations by conventional means and are at high risk for immediate desaturation during apnea and laryngoscopy. For these patients, more advanced methods to achieve preoxygenation and prevent desaturation are vital...
June 2011: Journal of Emergency Medicine
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