A novel application of Transnasal Humidified Rapid Insufflation Ventilatory Exchange via the oral route in morbidly obese patient during monitored anesthesia care -	A case report -

Jung, Jaewoong; Chung, Yang Hoon; Chae, Won Seok

doi:10.17085/apm.20043

Cited by 2 publications

(1 citation statement)

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“…Several studies have reported that pharyngeal catheters deliver oxygen more effectively to alveoli by reducing the distance from the oxygen outlet to the pharyngeal inlet. [9][10][11] A bronchial tube is inserted through the trachea into the bronchus, so that direct delivery of oxygen to the alveoli is possible. An open airway system produces a large amount of leakage, but this can be overcome by using a 70 l/min oxygen flow rate.…”

Section: Discussionmentioning

confidence: 99%

Apnoeic oxygenation using transnasal humidified rapid-insufflation ventilatory exchange during rigid bronchoscopy: a report of four cases

et al. 2022

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General anaesthesia with a muscle relaxant is usually performed for rigid bronchoscopy (RB), but ventilation is challenging due to large amounts of leakage. Optiflow™ supplies 100% humidified, warmed oxygen at a rate of up to 70 l/min and this high flow rate may overcome the leakage problem. This case report describes four patients that were scheduled for RB. The lung lesions were all located below the carina, so a bronchial tube was inserted under general anaesthesia. Once a large amount of leakage was confirmed by manual ventilation, Optiflow™ was connected to the bronchial tube (flow rate, 70 l/min). All of the ports of the bronchoscopy were left open to prevent the risk of outlet obstruction. Oxygenation was well maintained with stable vital signs throughout the procedures, which took up to 34 min without airway intervention. There were no occurrences of cardiac arrhythmia or changes in the electrocardiograms. Respiratory acidosis recovered after emergence, which was confirmed by arterial blood gas analysis in all cases. Apnoeic oxygenation using Optiflow™ was applied successfully during RB. Applying Optiflow™ could make cases of difficult ventilation during RB much easier for the anaesthetist. Larger studies need to demonstrate the efficacy and safety of this technique.

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Section: Discussionmentioning

confidence: 99%