Preoxygenation during induction of anesthesia in non-critically ill patients: A systematic review

Journal of Clinical Anesthesia
Elena BignamiLuigi Vetrugno

Abstract

We conducted a systematic review of the literature to better understand whether preoxygenation in non-critically ill patients (i.e. elective surgery patients) should be recommended, as it lengthens safe apnea time (the time required to reach oxygen saturation < 90% in an apneic patient). Furthermore, we looked for the most efficient technique amongst those currently employed in clinical practice. We searched Scopus, CINAHL, the Cochrane Library, PubMed and MeSH using various combinations of the words "preoxygenation", "general anesthesia", "induction", "operating room" and "oxygen". RCTs conducted on adult (>18 years) and non-emergent patients between 2008 and 2017 were deemed eligible. A total of 11 papers were included. Our review suggests that preoxygenation is a safe and efficient technique that allows for longer safe apneic periods in obese (BMI > 30) non-critically ill patients. Non-obese (<30 BMI) patients do not seem to benefit as much from this procedure. However, there is insufficient evidence in the literature to provide a clear recommendation. For all patients, the procedure was safe and well tolerated with no harm reported. The best technique for preoxygenation appears to be pressure support ventilation plus positi...Continue Reading

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Citations

Apr 25, 2021·Journal of Cardiothoracic and Vascular Anesthesia·Giovanni LandoniLuca Cabrini

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