Low-positive pressure ventilation improves non-hypoxaemic apnoea tolerance during ear, nose and throat pan-endoscopy: A randomised controlled trial.
Eur J Anaesthesiol
; 33(4): 269-74, 2016 Apr.
Article
in En
| MEDLINE
| ID: mdl-26716862
ABSTRACT
BACKGROUND:
It has been suggested that oxygenation using pressure support ventilation (PSV) before general anaesthesia can reduce the duration of non-hypoxaemic apnoea.OBJECTIVE:
The objective was to determine whether or not pre-oxygenation with PSV increases the duration of non-hypoxaemic apnoea in non-obese patients during pan-endoscopy.DESIGN:
A randomised, controlled trial.SETTING:
Amiens University Hospital, France. PATIENTS Fifty patients scheduled for ENT pan-endoscopy with a BMI lower than 35 âkg âm(-2). INTERVENTION Patients scheduled for pan-endoscopy were enrolled to receive either 100% oxygen at neutral pressure (the control group) or 100% oxygen with positive-pressure ventilation (a positive inspiratory pressure of 4â cmH2O and a positive end-expiratory pressure of 4â cmH2O; the PSV group) during spontaneous ventilation with a face mask. The goal of pre-oxygenation was to obtain an end-tidal oxygen concentration of more than 90% prior to induction of anaesthesia. MAIN OUTCOMEMEASURES:
The primary efficacy criterion was the duration of non-hypoxaemic apnoea (i.e. before the peripheral capillary oxygen saturation fell to 90%). Secondary outcomes were duration of pre-oxygenation, pre-oxygenation failure and tolerance.RESULTS:
The mean (interquartile range) duration of non-hypoxaemic apnoea was longer in the PSV group [598 (447 to 717) s] than in the control group [310 (217 to 451) s] (Pâ<â0.001). Oxygenation time was shorter in the PSV group [190 (159 to 225) s] than in the control group [245 (151 to 435) s] (Pâ=â0.037). Pre-oxygenation was unsuccessful (i.e. end-tidal oxygen concentration was < 90%) in 20% of the patients in the control group but none in the PSV group. The intergroup difference in the duration of pan-endoscopy was not significant. Tolerance was good or very good in all patients.CONCLUSION:
Our results show that pre-oxygenation with PSV is associated with a longer duration of non-hypoxaemic apnoea and a lower frequency of manual reventilation during ENT pan-endoscopy. CLINICALTRIALS. GOV REGISTRATION NUMBER NCT02167334.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Apnea
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Otorhinolaryngologic Surgical Procedures
/
Positive-Pressure Respiration
/
Laryngoscopy
/
Hypoxia
Type of study:
Clinical_trials
/
Diagnostic_studies
/
Etiology_studies
/
Guideline
Limits:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
Europa
Language:
En
Journal:
Eur J Anaesthesiol
Journal subject:
ANESTESIOLOGIA
Year:
2016
Document type:
Article
Country of publication:
ENGLAND
/
ESCOCIA
/
GB
/
GREAT BRITAIN
/
INGLATERRA
/
REINO UNIDO
/
SCOTLAND
/
UK
/
UNITED KINGDOM