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The effect of age and increasing head‐up tilt on pre‐oxygenation times in children: a randomised exploratory study
Author(s) -
Oshan V.,
Plant N.,
Gopal P.,
Rajai A.,
Roberts S. A.,
Walker R. W. M.
Publication year - 2016
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/anae.13379
Subject(s) - medicine , supine position , oxygenation , end point , age groups , pediatrics , anesthesia , demography , mathematics , geometry , sociology
Summary We conducted a randomised exploratory trial in children aged between one and sixteen years old to establish the time to achieve an end‐tidal oxygen fraction ≥ 0.9 in three different positions: supine, and 30 and 45° head up. We recruited 120 children analysed in two age groups: 1–8 years and 9–16 years. The median ( IQR [range]) time to reach the end point was 80 (59–114 [41‐295]) s in the younger group and 150 (107‐211 [44‐405]) s in the older group, regardless of position (p = 0.0001). The end point was reached in 90% of children in approximately 160 s in the younger, and 271 s in the older, groups, respectively. There was no statistical difference between the three positions within each age group in the time to reach the endpoint (p = 0.59). Only two patients in the older age group could not reach the end point, due to poorly fitting facemasks. We conclude that pre‐oxygenation can therefore be achieved effectively in most children, and that tilting children head up by 30 or 45° does not significantly reduce the time taken to achieve an end‐tidal oxygen fraction of ≥ 0.9. The recommended period for pre‐oxygenation in both groups should remain at 3 min but it should be noted that this may be insufficient for many older patients.