[Turk J Anaesthesiol Reanim]
Turk J Anaesthesiol Reanim. Baskıdaki Makaleler: TARD-47048 | DOI: 10.5152/TJAR.2017.47048  

Efficacy and safety of using high flow nasal oxygenation in patients undergoing rapid sequence intubation

Santi Maurizio Raineri, Andrea Cortegiani, Giuseppe Accurso, Claudia Procaccianti, Filippo Vitale, Sabrina Caruso, Antonino Giarratano, Cesare Gregoretti
Department of Biopathology and Medical Biotechnologies (DIBIMED). Section of Anesthesia, Analgesia, Intensive Care and Emergency. Policlinico Paolo Giaccone. University of Palermo, Italy

Objective: To assess the efficacy and safety of high flow nasal oxygen therapy (HFNO) in patients undergoing rapid sequence intubation (RSI) for emergency abdominal surgery.
Methods: HFNO was delivered at 60 L.min-1 at an inspiratory oxygen fraction (FiO2) of 1 four minutes before the laryngoscopy and then maintained until the patient was intubated and correct intubation was verified by the appearance of the end-tidal CO2 (EtCO2) waveform. SpO2, heart rate and noninvasive mean arterial pressure were monitored at baseline (T0), after 4 minutes on HFNO (T1), at the time of the laryngoscopy (T2) and at time of endotracheal intubation (ETI) (T3). SpO2 less than 3% from the baseline value was recorded at any sampled times. The value of EtCO2 at T3 was registered after two mechanical breaths. Apnea time was defined as the time from the end of propofol injection to ETI. RSI was carried out with propofol fentanyl and rocuronium.
Results: Forty-five patients were enrolled. The SpO2 levels were statistically significantly increased at the T1, T2 and T3 compared to the Baseline (T0) (p <0.05); median SpO2 % (interquartile range) was at T0 97 (96-99), T1 99 (99-100), T2 99 (99-100), T3 99 (99-100). Minimal SpO2 was 96%; no patients showed SpO2 less than 3% from the baseline; mean EtCO2 at the time of ETI was 36±4 mmHg. Maximum apnea time was 12 min.
Conclusion: HFNO is an effective and safe technique for pre-oxygenating in patients undergoing rapid sequence induction of general anesthesia for emergency surgery.

Keywords: Rapid sequence intubation, preoxygenation, high flow nasal oxygen therapy

Sorumlu Yazar: Andrea Cortegiani, Italy

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