Airway patency matters
| العنوان: | Airway patency matters |
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| المؤلفون: | Joana Ratsiu, Christer Jonmarker |
| المصدر: | Canadian Journal of Anesthesia/Journal canadien d'anesthésie. 57:387-388 |
| بيانات النشر: | Springer Science and Business Media LLC, 2010. |
| سنة النشر: | 2010 |
| مصطلحات موضوعية: | medicine.medical_specialty, Airway patency, Apneic oxygenation, Resorption Atelectasis, business.industry, Apnea, General Medicine, Airway occlusion, Shunting, Anesthesiology and Pain Medicine, Functional residual capacity, Anesthesia, medicine, medicine.symptom, Intensive care medicine, Airway, business |
| الوصف: | To the Editor, In their review of preoxygenation, Tanoubi et al. calculated that a preoxygenated adult patient has a pulmonary oxygen reserve that would last nine minutes should the patient become apneic. They base this calculation on estimates of available pulmonary oxygen reserves and oxygen consumption. Although the calculation is theoretically attractive because it illustrates the difference in oxygen reserves in non-preoxygenated and preoxygenated patients, we would argue that the calculation has little clinical relevance. What really matters under those circumstances is whether or not the upper airway is open. The principles of apneic oxygenation (well described 50 years ago) apply in a patient with an open airway. As long as oxygen is flushing over the airway, desaturation might not occur for 50 min or longer. Unfortunately, the nine-minute calculation is also misleading when the upper airway is not open, because the fact that oxygen causes resorption atelectasis is not taken into account. Functional residual capacity will decrease in a healthy adult patient by about 200 mL during the first minute after airway occlusion. Pulmonary shunting can then cause more rapid desaturation, even in patients who are well preoxygenated. Therefore, to take advantage of the principles of apneic oxygenation, it is important to maintain an open airway during induction and to retain an open airway during apnea while oxygen is dispersed over the patient’s face. Although Tanoubi et al. gave an otherwise good review of an interesting subject, we feel that clarifying these issues would have improved their article. Funding The authors have had no funding for the present work and have no association with any individuals or organization that could constitute a conflict of interest in relation to this submission. |
| تدمد: | 1496-8975 0832-610X |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_________::be6e2e0f816a3a789c0890ca13ca22fd https://doi.org/10.1007/s12630-010-9268-6 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi...........be6e2e0f816a3a789c0890ca13ca22fd |
| قاعدة البيانات: | OpenAIRE |
Find this article in full text from Springer Verlag. | تدمد: | 14968975 0832610X |
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