The obstetric airway: things are seldom as they seem

Douglas, M. Joanne; Preston, Roanne

doi:10.1007/s12630-011-9492-8

Cited by 23 publications

(12 citation statements)

References 17 publications

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“…However, despite the importance of pre‐oxygenation, it is often performed poorly in obstetric patients due to air entrainment even around a tight‐fitting facemask . Furthermore, the requirement for rapid delivery of the fetus, along with well‐recognised time pressures and human factor issues can all make pre‐oxygenation suboptimal . The accepted standard of practice for pre‐oxygenation is that parturients undergoing general anaesthesia either complete 3 min of tidal volume breathing or eight vital capacity breaths via a facemask, with both methods being considered to be equally effective .…”

Section: Introductionmentioning

confidence: 99%

High‐flow nasal oxygen vs. standard flow‐rate facemask pre‐oxygenation in pregnant patients: a randomised physiological study

et al. 2019

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High-flow nasal oxygen has been shown to provide effective pre-oxygenation and prolong apnoeic time during intubation attempts in non-pregnant patients. We aimed to compare pre-oxygenation using high-flow nasal oxygen (30-70 l.min À1 oxygen flow) via nasal prongs with standard 15 l.min À1 oxygen breathing via a tightfitting facemask. Forty healthy parturients were randomly allocated to these two groups, and furthermore each patient underwent the selected pre-oxygenation method with both 3-min tidal volume breathing and 30s tidal breathing followed by eight vital capacity breaths. With 3-min tidal volume breathing, the respective estimated marginal means for high-flow nasal oxygen and standard flow rate facemask pre-oxygenation were 87.4% (95% CI 85.5-89.2%) and 91.0% (95%CI 89.3-92.7%), p = 0.02; with eight vital capacity breaths the estimated marginal means were 85.9% (95%CI 84.1-87.7%) and 91.8% (95%CI 90.1-93.4%, p < 0.0001). Furthermore, high-flow nasal oxygen did not reliably achieve a mean end-tidal oxygen concentration ≥ 90% compared with the standard flow rate facemask. In this physiological study, high-flow nasal oxygen pre-oxygenation performed worse than standard flow rate facemask pre-oxygenation in healthy term parturients.

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Section: Introductionmentioning

confidence: 99%

High‐flow nasal oxygen vs. standard flow‐rate facemask pre‐oxygenation in pregnant patients: a randomised physiological study

et al. 2019

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“…Airway-related complications in obstetric patients can be minimized by identifying the high-risk patients and referring them to obstetric anaesthetic clinics in the antenatal period to allow the opportunity for airway assessment and appropriate planning [5].…”

Section: Airway Assessmentmentioning

confidence: 99%

Airway management and training in obstetric anaesthesia

Mushambi

Jaladi

2016

Current Opinion in Anaesthesiology

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Recent advances and recommendations in the management of the obstetric airway should help to bring consistency of clinical practice, reduce adverse events, and standardize teaching by providing a structure for teaching and training on failed tracheal intubation in obstetrics. Opportunities during elective caesarean sections and simulation should be used as teaching tools to improve anaesthetists' and team performance during a crisis.

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“…41,42 Effective training can, and has, improved management of the airway, 43 but needs to include not only individual skill acquisition but also practice of the nontechnical skills learned in team training during drills and simulations. 48 Simulation and training drills can also help identify systemic barriers that may impede efficient care and patient safety.…”

Section: Human Factorsmentioning

confidence: 99%