Use of a human patient simulator for apnea studies: a preliminary in vitro trial
Background Modern human patient simulators (HPSs) could be used for researching critical scenarios such as apnea oxygenation. We aimed to study the use of a high-fidelity HPS to assess prolonged apnea using various oxygenation strategies with a simple high-flow nasal cannula (15 L/min). Methods An e...
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| Format: | Article |
| Language: | English |
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Korean Society of Anesthesiologists
2022-10-01
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| Series: | Korean Journal of Anesthesiology |
| Subjects: | |
| Online Access: | http://ekja.org/upload/pdf/kja-22240.pdf |
| _version_ | 1811196278535618560 |
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| author | Debendra Kumar Tripathy Mridul Dhar Bharat Bhushan Bhardwaj K Hemanthkumar Praveen Talawar Shalinee Rao |
| author_facet | Debendra Kumar Tripathy Mridul Dhar Bharat Bhushan Bhardwaj K Hemanthkumar Praveen Talawar Shalinee Rao |
| author_sort | Debendra Kumar Tripathy |
| collection | DOAJ |
| description | Background Modern human patient simulators (HPSs) could be used for researching critical scenarios such as apnea oxygenation. We aimed to study the use of a high-fidelity HPS to assess prolonged apnea using various oxygenation strategies with a simple high-flow nasal cannula (15 L/min). Methods An experimental simulation study using an HPS (CAE Healthcare™) was conducted after obtaining approval from the Institutional Review Board. The HPS responded according to real-time physiologically modeled responses to external gases, such as oxygen (O2). Apnea experiments were performed with different physiological settings, such as shunt fraction (5%) and O2 consumption (250, 500, and 750 ml/min). The following four apnea experiments were conducted: no oxygenation (NO), apnea oxygenation alone (AO), preoxygenation alone (PO), and para-oxygenation (PAO). The time to 92%, 75%, and 50% saturation was recorded. Alveolar and arterial gas levels were recorded till 50% saturation. Results At 250 ml/min, PO (1121 s) and PAO (1274.5 s) had a significantly longer time to 50% saturation (400% increase) compared to NO (222.5 s) and AO (239 s). A similar trend was observed for the time to 92% and 75% saturation. At higher O2 consumption rates, a shorter time to desaturation was observed. Conclusions Apnea trends in the HPS correlated with similar prior human experiments. AO without preoxygenation was found to provide no additional benefit. Preoxygenation with high-flow O2 via nasal cannula prolonged the time to desaturation in the PAO more than PO scenario. Therefore, HPSs can be used in future studies where patient safety is a concern. |
| first_indexed | 2024-04-12T00:57:01Z |
| format | Article |
| id | doaj.art-7bd18ec35fee4462921d1d57bff39558 |
| institution | Directory Open Access Journal |
| issn | 2005-6419 2005-7563 |
| language | English |
| last_indexed | 2024-04-12T00:57:01Z |
| publishDate | 2022-10-01 |
| publisher | Korean Society of Anesthesiologists |
| record_format | Article |
| series | Korean Journal of Anesthesiology |
| spelling | doaj.art-7bd18ec35fee4462921d1d57bff395582022-12-22T03:54:36ZengKorean Society of AnesthesiologistsKorean Journal of Anesthesiology2005-64192005-75632022-10-0175543744410.4097/kja.222408819Use of a human patient simulator for apnea studies: a preliminary in vitro trialDebendra Kumar Tripathy0Mridul Dhar1Bharat Bhushan Bhardwaj2K Hemanthkumar3Praveen Talawar4Shalinee Rao5 Department of Anesthesiology and Critical Care, All India Institute of Medical Sciences, Rishikesh, India Department of Anesthesiology and Critical Care, All India Institute of Medical Sciences, Rishikesh, India Department of Emergency Medicine, All India Institute of Medical Sciences, Rishikesh, India Advanced Center for Simulation and Skills, All India Institute of Medical Sciences Rishikesh, India Department of Anesthesiology and Critical Care, All India Institute of Medical Sciences, Rishikesh, India Advanced Center for Simulation and Skills, All India Institute of Medical Sciences Rishikesh, IndiaBackground Modern human patient simulators (HPSs) could be used for researching critical scenarios such as apnea oxygenation. We aimed to study the use of a high-fidelity HPS to assess prolonged apnea using various oxygenation strategies with a simple high-flow nasal cannula (15 L/min). Methods An experimental simulation study using an HPS (CAE Healthcare™) was conducted after obtaining approval from the Institutional Review Board. The HPS responded according to real-time physiologically modeled responses to external gases, such as oxygen (O2). Apnea experiments were performed with different physiological settings, such as shunt fraction (5%) and O2 consumption (250, 500, and 750 ml/min). The following four apnea experiments were conducted: no oxygenation (NO), apnea oxygenation alone (AO), preoxygenation alone (PO), and para-oxygenation (PAO). The time to 92%, 75%, and 50% saturation was recorded. Alveolar and arterial gas levels were recorded till 50% saturation. Results At 250 ml/min, PO (1121 s) and PAO (1274.5 s) had a significantly longer time to 50% saturation (400% increase) compared to NO (222.5 s) and AO (239 s). A similar trend was observed for the time to 92% and 75% saturation. At higher O2 consumption rates, a shorter time to desaturation was observed. Conclusions Apnea trends in the HPS correlated with similar prior human experiments. AO without preoxygenation was found to provide no additional benefit. Preoxygenation with high-flow O2 via nasal cannula prolonged the time to desaturation in the PAO more than PO scenario. Therefore, HPSs can be used in future studies where patient safety is a concern.http://ekja.org/upload/pdf/kja-22240.pdfapneahypoxianasal cannulaoxygen inhalation therapyoxygen saturationpatient simulation |
| spellingShingle | Debendra Kumar Tripathy Mridul Dhar Bharat Bhushan Bhardwaj K Hemanthkumar Praveen Talawar Shalinee Rao Use of a human patient simulator for apnea studies: a preliminary in vitro trial Korean Journal of Anesthesiology apnea hypoxia nasal cannula oxygen inhalation therapy oxygen saturation patient simulation |
| title | Use of a human patient simulator for apnea studies: a preliminary in vitro trial |
| title_full | Use of a human patient simulator for apnea studies: a preliminary in vitro trial |
| title_fullStr | Use of a human patient simulator for apnea studies: a preliminary in vitro trial |
| title_full_unstemmed | Use of a human patient simulator for apnea studies: a preliminary in vitro trial |
| title_short | Use of a human patient simulator for apnea studies: a preliminary in vitro trial |
| title_sort | use of a human patient simulator for apnea studies a preliminary in vitro trial |
| topic | apnea hypoxia nasal cannula oxygen inhalation therapy oxygen saturation patient simulation |
| url | http://ekja.org/upload/pdf/kja-22240.pdf |
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