Factors influencing oxygen store during denitrogenation in the healthy patient

Abstract Study Objective To define the various factors that influence the rate of effective preoxygenation. Design Prospective, randomized study. Setting Procedure room in a teaching hospital. Subjects 14 ASA physical status I volunteers who performed 4 sessions of breathing in random order. Of thes...

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Bibliographic Details
Published in:Journal of clinical anesthesia 2009-05, Vol.21 (3), p.183-189
Main Authors: Sum Ping, Sam (John) T., MB ChB, FRCA, Makary, Laila F., MB, BCh, MD, Van Hal, Michael D., BS
Format: Article
Language:English
Subjects:
Adult
Anesthesia
Anesthesia & Perioperative Care
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Carbon dioxide
Carbon Dioxide - metabolism
Denitrogenation
Female
Gas flow
Hospitals, Teaching
Humans
Male
Medical sciences
Middle Aged
Nitrogen
Nitrogen - metabolism
Oxygen
Oxygen - administration & dosage
Oxygen - metabolism
Pain Medicine
Preoxygenation
Prospective Studies
Respiratory Physiological Phenomena
Respiratory physiology
Studies
Ventilation
Vital Capacity - physiology
Volunteers
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Summary:Abstract Study Objective To define the various factors that influence the rate of effective preoxygenation. Design Prospective, randomized study. Setting Procedure room in a teaching hospital. Subjects 14 ASA physical status I volunteers who performed 4 sessions of breathing in random order. Of these volunteers, 7 performed two extra sessions using vital capacity breathing, which were also completed in random order. Interventions Using the circle system, volunteers breathed with a mouthpiece and nose-clip until expired nitrogen reached 5%, using either a fresh gas flow of 5 L/min or 10 L/min or a system flushed with O2. Measurements End-expired levels of O2 , nitrogen, and CO2 were recorded. Main Results Minute ventilation, functional residual capacity, and age were significant factors for rate of denitrogenation. However, height and weight were not significant factors in predicting time to denitrogenation. At low flow rates, flushing with O2 significantly decreased the time of denitrogenation. There appeared to be little clinical benefit of flushing with O2 when a 10 L/min O2 flow was used. Conclusions A high gas flow rate appears critical to achieving rapid preoxygenation.
ISSN:0952-8180
1873-4529
DOI:10.1016/j.jclinane.2008.07.004