Effect of high fresh gas flow and pattern of breathing on rapid preoxygenation
Background and Aims: Preoxygenation is supplementation of 100% oxygen prior to induction of general anaesthesia to increase the body's oxygen stores. Efficacy of preoxygenation can be increased by optimising fresh gas flow (FGF) rate and pattern of breathing. Methods: Based on pattern of breath...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2022-01-01
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| Series: | Indian Journal of Anaesthesia |
| Subjects: | |
| Online Access: | http://www.ijaweb.org/article.asp?issn=0019-5049;year=2022;volume=66;issue=3;spage=213;epage=219;aulast=Mathew |
| _version_ | 1817997673098117120 |
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| author | Gincy Mathew M Manjuladevi Nayanthara Joachim Apoorwa N Kothari |
| author_facet | Gincy Mathew M Manjuladevi Nayanthara Joachim Apoorwa N Kothari |
| author_sort | Gincy Mathew |
| collection | DOAJ |
| description | Background and Aims: Preoxygenation is supplementation of 100% oxygen prior to induction of general anaesthesia to increase the body's oxygen stores. Efficacy of preoxygenation can be increased by optimising fresh gas flow (FGF) rate and pattern of breathing. Methods: Based on pattern of breathing—Tidal Volume Breathing (TVB) or Deep Breathing (DB) and FGF-10 L/min or 15 L/min—100 subjects of the American Society of Anesthesiologists physical status I/II posted for elective surgery were recruited and randomised into four groups: T10 - TVB with 10 L/min; D10 - DB with 10 L/min; T15 - TVB with 15 L/min; and D15 - DB with 15 L/min. A tight-fitting anaesthesia mask along with continuous positive airway pressure of 5 cm of H2O with 20° head-up was used for preoxygenation. The total time taken and the total number of breaths required to achieve end tidal oxygen concentration (EtO2) of 90% were noted. Exhaled tidal volume (Vte), end tidal carbon dioxide, fraction of inspired oxygen, and EtO2 were recorded at each breath. Analysis of variance (ANOVA) was used for inferential statistics and Tukey's honestly significant difference (HSD) test was used to calculate mean difference in total time and number of breaths amongst the groups. Results: Total time taken was significantly low (P < 0.001) in DB compared to TVB (D10: 70.2 ± 19.91, D15: 68.4 ± 20.27 vs T10: 112.28 ± 47.96, T15: 113.6 ± 48.57 seconds). Number of breaths was significantly high (P < 0.001) in TVB with 22.84 ± 8.73, 23.76 ± 11.64, 10.56 ± 3.69, and 8.32 ± 1.8 in T10, T15, D10 and D15, respectively. Vte was significantly low in TVB (P < 0.001). Conclusion: Rapid preoxygenation can be achieved by DB at high FGF of a minimum of 10 L/min. |
| first_indexed | 2024-04-14T02:41:53Z |
| format | Article |
| id | doaj.art-fa5d7915121b4a19a5406e0b992738d9 |
| institution | Directory Open Access Journal |
| issn | 0019-5049 0976-2817 |
| language | English |
| last_indexed | 2024-04-14T02:41:53Z |
| publishDate | 2022-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Anaesthesia |
| spelling | doaj.art-fa5d7915121b4a19a5406e0b992738d92022-12-22T02:17:02ZengWolters Kluwer Medknow PublicationsIndian Journal of Anaesthesia0019-50490976-28172022-01-0166321321910.4103/ija.ija_340_21Effect of high fresh gas flow and pattern of breathing on rapid preoxygenationGincy MathewM ManjuladeviNayanthara JoachimApoorwa N KothariBackground and Aims: Preoxygenation is supplementation of 100% oxygen prior to induction of general anaesthesia to increase the body's oxygen stores. Efficacy of preoxygenation can be increased by optimising fresh gas flow (FGF) rate and pattern of breathing. Methods: Based on pattern of breathing—Tidal Volume Breathing (TVB) or Deep Breathing (DB) and FGF-10 L/min or 15 L/min—100 subjects of the American Society of Anesthesiologists physical status I/II posted for elective surgery were recruited and randomised into four groups: T10 - TVB with 10 L/min; D10 - DB with 10 L/min; T15 - TVB with 15 L/min; and D15 - DB with 15 L/min. A tight-fitting anaesthesia mask along with continuous positive airway pressure of 5 cm of H2O with 20° head-up was used for preoxygenation. The total time taken and the total number of breaths required to achieve end tidal oxygen concentration (EtO2) of 90% were noted. Exhaled tidal volume (Vte), end tidal carbon dioxide, fraction of inspired oxygen, and EtO2 were recorded at each breath. Analysis of variance (ANOVA) was used for inferential statistics and Tukey's honestly significant difference (HSD) test was used to calculate mean difference in total time and number of breaths amongst the groups. Results: Total time taken was significantly low (P < 0.001) in DB compared to TVB (D10: 70.2 ± 19.91, D15: 68.4 ± 20.27 vs T10: 112.28 ± 47.96, T15: 113.6 ± 48.57 seconds). Number of breaths was significantly high (P < 0.001) in TVB with 22.84 ± 8.73, 23.76 ± 11.64, 10.56 ± 3.69, and 8.32 ± 1.8 in T10, T15, D10 and D15, respectively. Vte was significantly low in TVB (P < 0.001). Conclusion: Rapid preoxygenation can be achieved by DB at high FGF of a minimum of 10 L/min.http://www.ijaweb.org/article.asp?issn=0019-5049;year=2022;volume=66;issue=3;spage=213;epage=219;aulast=Mathewapnoeahypoxiaoxygentidal volumevital capacity |
| spellingShingle | Gincy Mathew M Manjuladevi Nayanthara Joachim Apoorwa N Kothari Effect of high fresh gas flow and pattern of breathing on rapid preoxygenation Indian Journal of Anaesthesia apnoea hypoxia oxygen tidal volume vital capacity |
| title | Effect of high fresh gas flow and pattern of breathing on rapid preoxygenation |
| title_full | Effect of high fresh gas flow and pattern of breathing on rapid preoxygenation |
| title_fullStr | Effect of high fresh gas flow and pattern of breathing on rapid preoxygenation |
| title_full_unstemmed | Effect of high fresh gas flow and pattern of breathing on rapid preoxygenation |
| title_short | Effect of high fresh gas flow and pattern of breathing on rapid preoxygenation |
| title_sort | effect of high fresh gas flow and pattern of breathing on rapid preoxygenation |
| topic | apnoea hypoxia oxygen tidal volume vital capacity |
| url | http://www.ijaweb.org/article.asp?issn=0019-5049;year=2022;volume=66;issue=3;spage=213;epage=219;aulast=Mathew |
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