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Apneic oxygenation

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4 papers 0 to 25 followers
By Jason Mann No BS pulmonary critical care fellow
Matthew W Semler, David R Janz, Robert J Lentz, Daniel T Matthews, Brett C Norman, Tufik R Assad, Raj D Keriwala, Benjamin A Ferrell, Michael J Noto, Andrew C McKown, Emily G Kocurek, Melissa A Warren, Luis E Huerta, Todd W Rice
RATIONALE: Hypoxemia is common during endotracheal intubation of critically ill patients and may predispose to cardiac arrest and death. Administration of supplemental oxygen during laryngoscopy (apneic oxygenation) may prevent hypoxemia. OBJECTIVES: To determine if apneic oxygenation increases the lowest arterial oxygen saturation experienced by patients undergoing endotracheal intubation in the intensive care unit. METHODS: This was a randomized, open-label, pragmatic trial in which 150 adults undergoing endotracheal intubation in a medical intensive care unit were randomized to receive 15 L/min of 100% oxygen via high-flow nasal cannula during laryngoscopy (apneic oxygenation) or no supplemental oxygen during laryngoscopy (usual care)...
February 1, 2016: American Journal of Respiratory and Critical Care Medicine
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
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
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