Canis ISSN: 2398-2942

Preoxygenation

Contributor(s): Graham Bilbrough, Sheilah Robertson

Introduction

  • Administration of 100% oxygen before induction of anesthesia prolongs the time to onset of arterial hypoxemia Hypoxemia. This technique increases the bodys oxygen stores, primarily in the functional residual capacity (FRC) of the lungs.
  • In humans preoxygenation can be achieved with normal tidal volume breathing for 3-5 minutes or by 4-8 voluntary deep breaths. In animals only the normal breathing strategy while 100% oxygen is administered can be used.

Uses

  • Used prior to induction of anesthesia Anesthetic induction: overview in animals that are at high risk for oxygen desaturation; this includes obese animals, pregnant animals, critically ill animals and when a difficult intubation is anticipated, eg brachycephalic breeds of dog or in animals that have sustained facial trauma. Any animal with respiratory compromise may have a compromised FRC and benefit from preoxygenation. This technique can also be used when intubation will not be performed immediately after induction of anesthesia, eg when a laryngeal examination is required, or bronchoscopy or bronchiolar lavage will be performed.

Advantages

  • Easily performed technique, can prevent severe complications during induction and intubation, requires simple equipment.

Disadvantages

  • Some animals may resent the placement of a mask over their face and struggle making the procedure impossible. In addition struggling will increase the oxygen demand of the animal cancelling any potential benefits. This procedure delays the start of anesthesia and the planned procedure so the pros and cons need to be considered and weighed up against each other.

Requirements

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Preparation

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Procedure

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Aftercare

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references fromPubMed.
  • Dixon B J, Dixon J B, Carden J R, Burn A J, Schachter L M, Playfair J Met al(2005)Preoxygenation is more effective in the 25 degrees head-up position than in the supine position in severely obese patients: a randomized controlled study.Anesthesiology102(6), 1110-1115; discussion 1115APubMed.
  • Mort T C (2005)Preoxygenation in critically ill patients requiring emergency tracheal intubation.Crit Care Med33(11):2672-2675PubMed.
  • Chiron B, Laffon M, Ferrandiere M, Pittet J F, Marret H, Mercier C (2004)Standard preoxygenation technique versus two rapid techniques in pregnant patients.Int J Obstet Anesth13(1), 11-14PubMed.
  • Pandit J J, Duncan T, Robbins P A (2003)Total oxygen uptake with two maximal breathing techniques and the tidal volume breathing technique: a physiologic study of preoxygenation.Anesthesiology99(4), 841-846PubMed.
  • Baraka A S, Taha S K, Aouad M T, El-Khatib M F, Kawkabani N I (1999)Preoxygenation: comparison of maximal breathing and tidal volume breathing techniques.Anesthesiology91(3), 612-616PubMed.


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