Time to adequate oxygenation following ventilation using the Enk oxygen flow modulator versus a jet ventilator via needle cricothyrotomy in rabbits

Summary Introduction Limited information is available on the management of the ‘cannot intubate, cannot ventilate’ (CICV) situation in infants. We compared the time to achieve adequate oxygenation following rescue ventilation using the Enk oxygen flow modulator (OFM) with a jet ventilator in a simul...

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Bibliographic Details
Published in:Pediatric anesthesia 2014-02, Vol.24 (2), p.208-213
Main Authors: Wong, Carrie F. P., Yuen, Vivian M., Wong, Gordon T. C., To, Jensen, Irwin, Michael G.
Format: Article
Language:English
Subjects:
animal model
Animals
Apnea - therapy
Blood Gas Analysis
Blood Pressure - physiology
Carbon Dioxide - blood
children
Cricoid Cartilage - surgery
difficult airway
Feasibility Studies
Heart Rate - physiology
High-Frequency Jet Ventilation - instrumentation
High-Frequency Jet Ventilation - methods
Hydrogen-Ion Concentration
Hypoxia - therapy
infant
Oxygen - blood
Rabbits
Respiration, Artificial - methods
Thyroidectomy - methods
Treatment Outcome
Ventilators, Mechanical
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Summary:Summary Introduction Limited information is available on the management of the ‘cannot intubate, cannot ventilate’ (CICV) situation in infants. We compared the time to achieve adequate oxygenation following rescue ventilation using the Enk oxygen flow modulator (OFM) with a jet ventilator in a simulated CICV situation using the rabbit as an infant respiratory model. Methods Following institutional ethics committee approval, needle cricothyrotomy was performed under direct vision in nine anesthetized rabbits following surgical exposure of the larynx. After ensuring adequate level of anesthesia and analgesia, and confirming proper positioning of the 18G cannula, apnea was induced by the administration of myorelaxant and the SpO2 was allowed to drop to 75% before initiating rescue ventilation via either the OFM or jet ventilator. Results Five rabbits were ventilated with the OFM and four with the jet ventilator. Ventilation was maintained with either device for 15 min. All rabbits were successfully rescued using either device. There was no statistical difference in the time required for SpO2 to return to 80%, 85%, 90%, and 95%. Conclusions Both devices facilitated successful rescue ventilation through a needle cricothyrotomy.
ISSN:1155-5645
1460-9592
DOI:10.1111/pan.12289