Preoxygenation: Comparison of Maximal Breathing and Tidal Volume Techniques

Baraka, Anis

doi:10.1097/00000542-200006000-00056

Cited by 59 publications

(84 citation statements)

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“…Common reasons for the failure to achieve an FIO 2 close to 1.0 include inadequate time for preoxygenation, 10,12 a leak under the face mask, 2,5,10,17 use of systems incapable of delivering high oxygen concentrations, 18 and rebreathing of exhaled gases, such as when low FGF is used in a semiclosed circle absorber system. 7,8 In the current study, the subjects were non-bearded and were familiar with the use of tight-fitting masks so as to avoid leaks between the mask and the face. In addition, the clinical endpoints indicative of a sealed system (expansion and contraction of the reservoir bag corresponding with the respiratory cycle, measurement of breath-by-breath respiratory gases, and the presence of a normal capnogram) were confirmed in all subjects.…”

Section: Discussionmentioning

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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Section: Discussionmentioning

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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“…Furthermore, careful pre-oxygenation of each patient may render the patient an indirect controller of his anaesthesia machine. An increase in oxygen saturation while a high F I O 2 is indicated suggests that the anaesthesia machine is working properly [28,29]. In contrast, falling oxygen saturation during pre-oxygenation may indicate insufflation of an hypoxic gas mixture.…”

Section: ó 2007 the Authorsmentioning

confidence: 99%

Fatal errors in nitrous oxide delivery

et al. 2007

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SummaryNitrous oxide continues to be used frequently and the possibility of inadvertent fatal hypoxaemia resulting from technical errors with its administration still exists. A Medline analysis revealed only a few case reports over the last 30 years, and a closed claim analysis only reported ‘claims involving oxygen supply lines’ predating 1990. The aim of this study was to assess the frequency of nitrous oxide‐related catastrophes during general anaesthesia in Germany, Austria, and Switzerland. As nitrous oxide‐related anaesthesia casualties are rare but generally prosecuted, they almost invariably attract significant media attention. We scanned mass media archives from April 2004 until October 2006 for nitrous oxide‐related disasters during general anaesthesia. This approach detected six incidents which were almost certainly nitrous oxide ventilation‐related deaths. Searching non‐scientific data bases demonstrates that severe incidents involving oxygen supply lines occurred after 1990, and may be much more frequent than previously thought.

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“…It is somewhat surprising to learn that whilst the Department of Health has issued guidance on issues as diverse as West Nile fever [1] and botulism [2], it has yet to issue formal guidance on the use of specialist beds and pressure sores. However, on the 22nd September 2005 the National Institute for Clinical Excellence in conjunction with the Royal College of Nursing published a document entitled 'The Management of Pressure Ulcers in Primary and Secondary Care: A clinical practice guideline care' [3].…”

mentioning

confidence: 99%

“…Surely a common problem with clinical and financial implications merits medical recognition. We wish to comment on two papers recently published in Anaesthesia [1,2]. Both articles reported the incidence of hypothermia associated with the administration of intrathecal opioids for Caesarean section.…”

mentioning

confidence: 99%

“…That is why it is always safer to recommend that pre-oxygenation is standard during routine anaesthesia. For those patients who cannot tolerate a face mask during the traditional tidal volume breathing for 3-5 min, or whenever fast induction of general anaesthesia is indicated, rapid pre-oxygenation can be adequately achieved by the eight deep-breaths technique within 60 s [2], or even by the single vital capacity breath technique [3].…”

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confidence: 99%

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