Pre‐oxygenation–how long?

Berthoud, Mirielle; Read, D. H.; Norman, John C.

doi:10.1111/j.1365-2044.1983.tb13925.x

Cited by 78 publications

(39 citation statements)

References 3 publications

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“…7,8 However, these preoxygenation techniques require a tightly fitting face mask, and do not account for the leaks that occur frequently in practice. [9][10][11][12] Leaks have been reported in 10 to 11.5% of subjects with no facial anomalies and normal dentition. 13,14 In real life, leaks probably occur even more frequently since we often preoxygenate patients who are edentulous, wear beards or mustaches, have a nasogastric tube in place, or cooperate poorly.…”

Section: Discussionmentioning

confidence: 99%

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When a leak is unavoidable, preoxygenation is equally ineffective with vital capacity or tidal volume breathing

Gagnon

Fortier

Donati

2006

Can J Anesth/J Can Anesth

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Purpose: Ideally, preoxygenation is performed using a tight fitting mask either by breathing normally for three to five minutes or with four to eight vital capacity (VC) breaths in 0.5 to one minute, but in practice leaks are frequent and sometimes unavoidable. This study was designed to determine which breathing method provided the best oxygenation in the presence of leak.Methods: Twenty volunteers were instructed to breathe from a circle circuit supplied with 6 L·min -1 of fresh oxygen. Each subject was tested under four situations selected in random order: 1) normal breathing for three minutes without leak; 2) normal breathing for three minutes with a leak; 3) four VCs in 30 sec without a leak; and 4) four VCs in 30 sec with a leak. The leak was created by a piece of size 18 French nasogastric tube, 5 cm long, taped under the face mask. Inspired and expired O 2 and CO 2 were sampled at the nostrils. Results: In the absence of a leak, the end-tidal oxygen fraction (F EO2 ) was greater after three minutes of tidal breathing (89 ± 3%; mean ± SD) in comparison with the response to four VCs (76 ± 7%; P < 0.001). Introduction of a leak decreased the F EO2 significantly (P < 0.001). With a leak, the F EO2 was similar with normal breathing (61 ± 8%) and after four VCs (59 ± 11%). Conclusion:Preoxygenation with tidal volume breathing for three minutes yields higher F EO2 in comparison to four VCs. If a small leak (4 mm internal diameter) is introduced, the F EO2 decreases significantly with both breathing methods to approximately 60%. Objectif

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Section: Discussionmentioning

confidence: 99%

“…10 Berthoud et al realized that allowing even one breath contaminated with air increased end-tidal nitrogen concentration markedly. 9 Drummond et al…”

mentioning

confidence: 99%

When a leak is unavoidable, preoxygenation is equally ineffective with vital capacity or tidal volume breathing

Gagnon

Fortier

Donati

2006

Can J Anesth/J Can Anesth

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“…For many years, the traditional tidal volume breathing (TVB) for three to five minutes has been commonly practiced. 4,5 The period required for preoxygenation has been shortened by using deep breathing (DB), as advocated by Gold et al, 6 who used four deep breaths in 30 sec and by Baraka et al 7 who recommended eight deep breaths within 60 sec. More recently, it has been found that extending the duration of DB to 1.5 or two minutes with high fresh gas flow (FGF) further improves the efficacy of preoxygenation.…”

Section: Résultats : La Respiration En Volume Courant Avec Une Expiramentioning

confidence: 99%

Efficacy of preoxygenation using tidal volume and deep breathing techniques with and without prior maximal exhalation

Nimmagadda

Salem

Joseph

et al. 2007

Can J Anesth/J Can Anesth

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Purpose:We evaluated the influence of prior maximal exhalation on preoxygenation in 15 adult volunteers using tidal volume breathing (TVB) for five minutes and deep breathing (DB) for two minutes with and without prior maximal exhalation.Methods: Inspired and end-tidal oxygen, nitrogen and carbon dioxide were monitored continuously and recorded during room air breathing and at 30-sec intervals during 100% oxygen TVB or DB (rate of 8 breaths·min -1 ).Results: Tidal volume breathing with prior maximal exhalation resulted in an end-tidal oxygen concentration (ETO 2 ) slightly higher (P = 0.028) at 0.5 and 1.0 min as compared with TVB without prior maximal exhalation at the same time periods. Regardless of whether TVB was preceded by maximal exhalation or not, 2.5 min was required to reach a mean ETO 2 value of 90% or higher. With DB, there were no differences in ETO 2 values at any time period and 1.5 min was required to reach an ETO 2 of 90% or greater, with or without prior maximal exhalation. Conclusions:Maximal exhalation prior to TVB slightly steepens the initial rise in ETO 2 during the first minute, but confers no real benefit if maximal preoxygenation is the goal. Maximal exhalation prior to DB has no added value in enhancing preoxygenation.

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“…por cerca de 2 a 5 minutos (Berthoud et al, 1983;McGowan, Skinner, 1995;Gerardi et al, 1996). Desta maneira, o doente estaria apto a tolerar alguns minutos de apneia sem queda da saturação de O 2.…”

Section: Figura 5 Frequência Das Causas Sriunclassified

“…A pré-oxigenação a 100%, mantendo a ventilação espontânea, sem a utilização da VPP, visa a reduzir os riscos associados à hiperinsuflação gástrica, como regurgitação e aspiração do conteúdo gástrico (Berthoud et al,, 1983 A compressão cricoide, também chamada de manobra de Sellick, consiste na aplicação de uma pressão contínua na cartilagem cricoide (Sellick,1961) e foi descrita, inicialmente, durante os procedimentos de anestesia. Na SRI é fundamental e amplamente recomendada, prevenindo a regurgitação passiva do conteúdo gástrico para a faringe e a insuflação gástrica durante a ventilação com pressão positiva e para prevenir a aspiração pulmonar durante o procedimento de IT (Walls, 2004;Walls et al, 2007;Ellis et al, 2007).…”

Section: Figura 5 Frequência Das Causas Sriunclassified

Avaliação da sequência rápida de intubação em pronto-socorro pediátrico terciário

Sukys¹

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Pre‐oxygenation–how long?

Cited by 78 publications

References 3 publications

When a leak is unavoidable, preoxygenation is equally ineffective with vital capacity or tidal volume breathing

When a leak is unavoidable, preoxygenation is equally ineffective with vital capacity or tidal volume breathing

Efficacy of preoxygenation using tidal volume and deep breathing techniques with and without prior maximal exhalation

Avaliação da sequência rápida de intubação em pronto-socorro pediátrico terciário

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