Fayed Mohamed, Maroun Wissam, Patel Nimesh, Galusca Dragos
Cardiothoracic Anesthesia, Montefiore Medical Center, Bronx, USA.
Anesthesiology, Pain Management and Perioperative Medicine, Henry Ford Health System, Detroit, USA.
Cureus. 2023 Dec 21;15(12):e50916. doi: 10.7759/cureus.50916. eCollection 2023 Dec.
Apneic oxygenation is a technique used during airway management procedures to maintain oxygenation and prevent desaturation during a lack of ventilation. Despite its importance, there is a lack of comprehensive information on how to achieve effective apneic oxygenation, leading to misunderstandings and suboptimal utilization of this technique. Apneic oxygenation involves several key steps. Firstly, patient selection is crucial, considering factors such as anticipated difficulty with airway management, reduced functional residual capacity, increased oxygen consumption, and medical conditions associated with impaired oxygenation. Secondly, adequate preoxygenation is essential to optimize oxygen reserves before the onset of apnea, utilizing methods like non-rebreather oxygen masks or specific breathing techniques. Thirdly, maintaining airway patency through techniques such as jaw thrust or nasopharyngeal airway placement allows for unobstructed airflow during the apneic period. Lastly, the selection of the appropriate oxygen delivery method, such as high-flow nasal oxygen or nasal cannula, depends on the patient's existing respiratory support. Despite the growing body of literature on apneic oxygenation, current review articles often lack a stepwise approach for its proper execution. This knowledge gap contributes to the misunderstanding and underutilization of this important tool during intubation and airway management. In conclusion, apneic oxygenation is a valuable technique for maintaining oxygenation during periods of apnea. However, the lack of comprehensive information and stepwise guidance in the current literature hinders its optimal utilization. Clear guidelines and educational resources should be developed to address this knowledge gap and ensure the safe and effective implementation of apneic oxygenation. By following a stepwise approach that includes patient selection, adequate preoxygenation, airway patency, and appropriate oxygen delivery, healthcare providers can enhance patient outcomes and minimize the risk of desaturation during airway management procedures.
窒息氧合是一种在气道管理操作过程中使用的技术,用于在通气不足期间维持氧合并防止血氧饱和度下降。尽管其很重要,但关于如何实现有效的窒息氧合缺乏全面的信息,这导致了对该技术的误解和利用不足。窒息氧合涉及几个关键步骤。首先,患者选择至关重要,要考虑诸如气道管理预期难度、功能残气量减少、氧消耗增加以及与氧合受损相关的医疗状况等因素。其次,充分的预充氧对于在窒息开始前优化氧储备至关重要,可采用非重复呼吸面罩或特定呼吸技术等方法。第三,通过托下颌或放置鼻咽气道等技术维持气道通畅,以便在窒息期间实现无障碍气流。最后,选择合适的氧输送方法,如高流量鼻导管吸氧或鼻导管,取决于患者现有的呼吸支持情况。尽管关于窒息氧合的文献越来越多,但当前的综述文章往往缺乏对其正确实施的逐步方法。这种知识差距导致在插管和气道管理期间对这一重要工具的误解和利用不足。总之,窒息氧合是在窒息期间维持氧合的一项有价值的技术。然而,当前文献中缺乏全面的信息和逐步指导妨碍了其最佳利用。应制定明确的指南和教育资源来填补这一知识差距,并确保窒息氧合的安全有效实施。通过遵循包括患者选择、充分预充氧、气道通畅和合适的氧输送在内的逐步方法,医疗保健提供者可以改善患者预后并在气道管理操作期间将血氧饱和度下降的风险降至最低。