Universität zu Köln

Wetsch, Wolfgang A. ORCID: 0000-0001-5800-6665, Schroeder, Daniel C., Herff, Susanne J., Boettiger, Bernd W., Wenzel, Volker and Herff, Holger (2022). Identification of the Optimal Position of a Nasal Oxygen Cannula for Apneic Oxygenation: A Technical Simulation. J. Clin. Med., 11 (22). BASEL: MDPI. ISSN 2077-0383

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Abstract

Background: In a cannot-ventilate-cannot-intubate situation, careful preoxygenation with high FiO(2) allowing subsequent apneic oxygenation can be life-saving. The best position for an oxygen supply line within the human airway at which oxygen insufflation is more effective than standard preoxygenation with a face mask is unknown. Methods: In this experimental study, we compared the effectiveness of preoxygenation by placing an oxygen cannula at the nose entrance, through the nose at the soft palatine, or at the base of the tongue; as a control we used ambient air. We connected a fully preoxygenated test lung on one side to an oximeter with a flow rate of 200 mL/min simulating the oxygen consumption of a normal adult on the other side of the trachea of an anatomically correctly shaped airway manikin over a 20 min observation period five times for each cannula placement in a random order. Results: The oxygen percentage in the test lung dropped from 100% in all groups to 53 +/- 1% in the ambient air control group, to 87 +/- 2% in the nasal cannula group, and to 96 +/- 2% in the soft palatine group; it remained at 99 +/- 1% in the base of the tongue group (p = 0.003 for the soft palatine vs. base of the tongue and p < 0.001 for all other groups). Conclusions: When simulating apneic oxygenation in a preoxygenated manikin, oxygen insufflation at the base of the tongue kept the oxygen percentage at baseline values of 99%, demonstrating a complete block of ambient air flowing into the airway of the manikin. Oxygen insufflation at the soft palatine or insufflation via a nasal cannula were less effective regarding this effect.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Wetsch, Wolfgang A. UNSPECIFIED orcid.org/0000-0001-5800-6665 UNSPECIFIED Schroeder, Daniel C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Herff, Susanne J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Boettiger, Bernd W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wenzel, Volker UNSPECIFIED UNSPECIFIED UNSPECIFIED Herff, Holger UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-679304
DOI:	10.3390/jcm11226809
Journal or Publication Title:	J. Clin. Med.
Volume:	11
Number:	22
Date:	2022
Publisher:	MDPI
Place of Publication:	BASEL
ISSN:	2077-0383
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language RAPID-SEQUENCE INDUCTION; PRE-OXYGENATION; LARYNGOSCOPE Multiple languages Medicine, General & Internal Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/67930