Non-invasive ventilation for preoxygenation before general anesthesia: a systematic review and meta-analysis of randomized controlled trials
Abstract Background and objectives Preoxygenation is crucial for providing sufficient oxygen reservoir to a patient before intubation and enables the extension of the period between breathing termination and critical desaturation (safe apnoea time). Conventionally, face mask ventilation is used for...
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| Format: | Article |
| Language: | English |
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BMC
2022-09-01
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| Series: | BMC Anesthesiology |
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| Online Access: | https://doi.org/10.1186/s12871-022-01842-y |
| _version_ | 1811236388205494272 |
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| author | Tsai-Lien Chiang Ka-Wai Tam Jui-Tai Chen Chung-Shun Wong Chun-Ting Yeh Ting-Yun Huang Jiann-Ruey Ong |
| author_facet | Tsai-Lien Chiang Ka-Wai Tam Jui-Tai Chen Chung-Shun Wong Chun-Ting Yeh Ting-Yun Huang Jiann-Ruey Ong |
| author_sort | Tsai-Lien Chiang |
| collection | DOAJ |
| description | Abstract Background and objectives Preoxygenation is crucial for providing sufficient oxygen reservoir to a patient before intubation and enables the extension of the period between breathing termination and critical desaturation (safe apnoea time). Conventionally, face mask ventilation is used for preoxygenation. Non-invasive ventilation is a new preoxygenation method. The study objective was to compare the outcomes of non-invasive ventilation and face mask ventilation for preoxygenation. Method PubMed, Embase, Cochrane Library, and the ClinicalTrials.gov registry were searched for eligible studies published from database inception to September 2021. Individual effect sizes were standardized, and a meta-analysis was conducted using random effects models to calculate the pooled effect size. Inclusion criteria were randomised controlled trials of comparing the outcomes of non-invasive ventilation or face mask ventilation for preoxygenation in patients scheduled for surgeries. The primary outcome was safe apnea time, and the secondary outcomes were post-operative complications, number of patients who achieved the expired O2 fraction (FeO2) after 3 min of preoxygenation, minimal SpO2 during tracheal intubation, partial pressure of oxygen in the arterial blood (PaO2) and partial pressure of carbon dioxide (PaCO2) after preoxygenation, and PaO2 and PaCO2 after tracheal intubation. Results 13 trials were eligible for inclusion in this study. Significant differences were observed in safe apnoea time, number of patients who achieved FeO2 90% after preoxygenation for 3 min, and PaO2 and PaCO2 after preoxygenation and tracheal intubation. Only in the non-obese subgroup, no significant difference was observed in safe apnoea time (mean difference: 125.38, 95% confidence interval: − 12.26 to 263.03). Conclusion Non-invasive ventilation appeared to be more effective than conventional methods for preoxygenation. We recommend non-invasive ventilation based on our results. |
| first_indexed | 2024-04-12T12:09:24Z |
| format | Article |
| id | doaj.art-bfcd5823841440e3b015445999462fe1 |
| institution | Directory Open Access Journal |
| issn | 1471-2253 |
| language | English |
| last_indexed | 2024-04-12T12:09:24Z |
| publishDate | 2022-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Anesthesiology |
| spelling | doaj.art-bfcd5823841440e3b015445999462fe12022-12-22T03:33:38ZengBMCBMC Anesthesiology1471-22532022-09-0122111410.1186/s12871-022-01842-yNon-invasive ventilation for preoxygenation before general anesthesia: a systematic review and meta-analysis of randomized controlled trialsTsai-Lien Chiang0Ka-Wai Tam1Jui-Tai Chen2Chung-Shun Wong3Chun-Ting Yeh4Ting-Yun Huang5Jiann-Ruey Ong6Division of Emergency Medicine, Department of Emergency and Critical Care, Taipei Medical University-Shuang Ho HospitalCenter for Evidence-Based Health Care, Taipei Medical University-Shuang Ho HospitalDepartment of Anesthesiology, Taipei Medical University-Shuang Ho HospitalDivision of Emergency Medicine, Department of Emergency and Critical Care, Taipei Medical University-Shuang Ho HospitalDivision of Emergency Medicine, Department of Emergency and Critical Care, Taipei Medical University-Shuang Ho HospitalDivision of Emergency Medicine, Department of Emergency and Critical Care, Taipei Medical University-Shuang Ho HospitalDivision of Emergency Medicine, Department of Emergency and Critical Care, Taipei Medical University-Shuang Ho HospitalAbstract Background and objectives Preoxygenation is crucial for providing sufficient oxygen reservoir to a patient before intubation and enables the extension of the period between breathing termination and critical desaturation (safe apnoea time). Conventionally, face mask ventilation is used for preoxygenation. Non-invasive ventilation is a new preoxygenation method. The study objective was to compare the outcomes of non-invasive ventilation and face mask ventilation for preoxygenation. Method PubMed, Embase, Cochrane Library, and the ClinicalTrials.gov registry were searched for eligible studies published from database inception to September 2021. Individual effect sizes were standardized, and a meta-analysis was conducted using random effects models to calculate the pooled effect size. Inclusion criteria were randomised controlled trials of comparing the outcomes of non-invasive ventilation or face mask ventilation for preoxygenation in patients scheduled for surgeries. The primary outcome was safe apnea time, and the secondary outcomes were post-operative complications, number of patients who achieved the expired O2 fraction (FeO2) after 3 min of preoxygenation, minimal SpO2 during tracheal intubation, partial pressure of oxygen in the arterial blood (PaO2) and partial pressure of carbon dioxide (PaCO2) after preoxygenation, and PaO2 and PaCO2 after tracheal intubation. Results 13 trials were eligible for inclusion in this study. Significant differences were observed in safe apnoea time, number of patients who achieved FeO2 90% after preoxygenation for 3 min, and PaO2 and PaCO2 after preoxygenation and tracheal intubation. Only in the non-obese subgroup, no significant difference was observed in safe apnoea time (mean difference: 125.38, 95% confidence interval: − 12.26 to 263.03). Conclusion Non-invasive ventilation appeared to be more effective than conventional methods for preoxygenation. We recommend non-invasive ventilation based on our results.https://doi.org/10.1186/s12871-022-01842-yPreoxygenationVentilationNon-invasive positive pressure ventilationApneaDesaturationMeta-analysis |
| spellingShingle | Tsai-Lien Chiang Ka-Wai Tam Jui-Tai Chen Chung-Shun Wong Chun-Ting Yeh Ting-Yun Huang Jiann-Ruey Ong Non-invasive ventilation for preoxygenation before general anesthesia: a systematic review and meta-analysis of randomized controlled trials BMC Anesthesiology Preoxygenation Ventilation Non-invasive positive pressure ventilation Apnea Desaturation Meta-analysis |
| title | Non-invasive ventilation for preoxygenation before general anesthesia: a systematic review and meta-analysis of randomized controlled trials |
| title_full | Non-invasive ventilation for preoxygenation before general anesthesia: a systematic review and meta-analysis of randomized controlled trials |
| title_fullStr | Non-invasive ventilation for preoxygenation before general anesthesia: a systematic review and meta-analysis of randomized controlled trials |
| title_full_unstemmed | Non-invasive ventilation for preoxygenation before general anesthesia: a systematic review and meta-analysis of randomized controlled trials |
| title_short | Non-invasive ventilation for preoxygenation before general anesthesia: a systematic review and meta-analysis of randomized controlled trials |
| title_sort | non invasive ventilation for preoxygenation before general anesthesia a systematic review and meta analysis of randomized controlled trials |
| topic | Preoxygenation Ventilation Non-invasive positive pressure ventilation Apnea Desaturation Meta-analysis |
| url | https://doi.org/10.1186/s12871-022-01842-y |
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