Preoxygenation with tidal volume and deep breathing techniques: the impact of duration of breathing and fresh gas flow

Anesthesia and Analgesia
Usharani NimmagaddaM I El-Orbany

Abstract

Various techniques of "preoxygenation" before anesthetic induction have been advocated, including tidal volume breathing (TVB) for 3-5 min, four deep breaths (DB) in 0.5 min, and eight DB in 1 min. However, no study has compared the effectiveness of these techniques, assessed extending deep breathing beyond 1 min, or investigated the influence of fresh gas flow (FGF) in the same subjects using a circle absorber system. In 24 healthy adult volunteers breathing oxygen from a circle absorber system by tight-fitting mask, we compared TVB/5 min and deep breathing at a rate of 4 DB/0.5 min for 2 min at 5, 7, and 10 L/min FGF. Inspired and end-tidal respiratory gases were measured at 0.5-min intervals. During TVB, end-tidal oxygen (ETO2) increased rapidly and plateaued by 2.5 min at 86%, 88%, and 88% with 5, 7 and 10 L/min FGF, respectively. ETO2 values of > or =90% were attained between 3 and 4 min. Four DB/0.5 min increased ETO2 to 75%, 77%, and 80% at 5, 7, and 10 L/min FGF. Eight DB/min resulted in ETO2 values of 82% and 87% at 7 and 10 L/min, respectively. Extending deep breathing to 1.5 and 2 min with 10 L/min FGF increased ETO2 by > or =90%, although a decrease in ETCo(2) was noted. We concluded that TVB/3-5 min was effective i...Continue Reading

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References

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Citations

Jan 17, 2007·Anaesthesia·R A McCahon, J G Hardman
Jan 19, 2017·Anesthesia and Analgesia·Usharani NimmagaddaGeorge J Crystal
Oct 23, 2003·Anesthesia and Analgesia·Anis S BarakaMahmoud M Alameddine
Aug 19, 2007·Der Anaesthesist·G SchälteD Henzler
Dec 24, 2005·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Caroline GagnonFrançois Donati
Jun 2, 2007·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Usharani NimmagaddaIstvan Miko
Apr 29, 2009·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Issam TanoubiFrançois Donati
Oct 5, 2006·Current Opinion in Anaesthesiology·Spyros D Mentzelopoulos, Maria J Tzoufi
Jun 15, 2010·Current Opinion in Anaesthesiology·Patrick BraunPeter Paal
May 8, 2021·Brazilian Journal of Anesthesiology·Yasin TaşkaldıranSüheyla Ünver

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