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Apnoeic oxygenation in pregnancy: a modelling investigation
Author(s) -
Pillai A.,
Chikhani M.,
Hardman J. G.
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.13563
Subject(s) - medicine , oxygenation , anesthesia , glottis , pregnancy , population , rapid sequence induction , surgery , intubation , larynx , environmental health , biology , genetics
Summary Recent studies have shown that nasal oxygen delivery can prolong the time to desaturation during apnoea in the non‐pregnant population. We investigated the benefits of apnoeic oxygenation during rapid sequence induction in the obstetric population using computational modelling. We used the Nottingham Physiology Simulator, and pre‐oxygenated seven models of pregnancy for 3 min using F i O 2 1.0, before inducing apnoea. We found that increasing F i O 2 at the open glottis increased the time to desaturation, extending the time taken for S a O 2 to reach 40% from 4.5 min to 58 min in the average parturient model (not in labour). Our study suggests that a small increase in time to desaturation could be achieved at F i O 2 0.4–0.6, which could be delivered by standard nasal cannulae. The greatest increases in time to desaturation were seen at F i O 2 1.0, which could be delivered by high‐flow nasal cannulae under ideal conditions.