Physiology of apnoea and the benefits of preoxygenation
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With atelectasis, pulmonary contusion, and other lung pathologies, functional residual capacity is diminished and the resultant shunt physiology renders preoxygenation with high FiO2 less effective in preventing desaturation.
“With atelectasis, pulmonary contusion, and other lung pathologies, the FRC is diminished and the resultant shunt physiology renders preoxygenation with a high FiO 2 less effective in preventing desaturation.[106][107][108]”
From Airway Management in Trauma (2018) · cites this paper as [108]
The ‘Functional residual capacity’ and ‘Physiological shunt and dead space’ sections say that lung disease can reduce FRC and that patients with both shunting and reduced FRC develop hypoxaemia sooner. The ‘Critical illness’ section reports a smaller benefit from preoxygenation in unstable critically ill patients. The paper does not specifically address atelectasis or pulmonary contusion, or establish that shunt physiology itself makes high-FiO₂ preoxygenation less effective in those conditions. (LLM, conf=0.84)
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Research works printed but not linked: 10
- Drummond GB, Park GR. Arterial oxygen saturation before intubation of the trachea-an assessment of techniques. Br J Anaesth 1984; 56: 987-92
- Heck Z, Stegmann JU, Lorenz C, Heck M, Schlack W. Acceptance of pre- oxygenation in clinical routine by patients and by anaesthesiologists. Anasthesiol Intensivemed Notfallmed Schmerzther 2001; 36: 471-5
- Hardman JG, Wills JS, Aitkenhead AR. Factors determining the onset and course of hypoxaemia during apnoea: an investigation using physio- logical modelling. Anesth Analg 2000; 90: 619-24
- Jense HG, Dubin SA, Silverstein PI, O'Leary-Escolas U. Effect of obesity on safe duration of apnoea in anesthetized humans. Anesth Analg 1991; 72: 89-93
- Tucker DH, Sieker HO. The effect of change in body position on lung volumes and intrapulmonary gas mixing in patients with obesity, heart failure and emphysema. Am Rev Resp Dis 1960; 82: 787-91
- Dixon BJ, Dixon JB, Carden JR, et al. Preoxygenation is more effective in the 258 head-up position than in the supine position in severely obese patients. Anesthesiology 2005; 102: 1110-5
- Baraka AS. Preoxygenation during pregnancy in the head-up versus the supine position. Anesthesiology 2006; 104: 1110-5
- Mort TC. Preoxygenation in critically ill patients requiring emergency tracheal intubation. Crit Care Med 2005; 33: 2672-5
- Heier T, Feiner JR, Lin J, Brown R, Caldwell JE. Hemoglobin desaturation after succinylcholine-induced apnea. Anesthesiology 2001; 94: 754-9
- Hardman JG, Wills JS. The development of hypoxaemia during apnoea in children: a computational modelling investigation. Br J Anaesth 2006; 97: 564-70 Please see multiple choice questions 1 -4 Physiology of apnoea and the benefits of preoxygenation
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Kovacs, G., & Sowers, N. (2018) · Emergency Medicine Clinics of North America · doi:10.1016/j.emc.2017.08.006 · Cited by 115 · see citing works
- Authors
- Sirian, R., & Wills, J.
- Affiliations
- Queen's Medical Centre (GB)
- North Bristol NHS Trust (GB)
- Corresponding author
- Wills, Jonathan
- Venue
- Continuing Education in Anaesthesia Critical Care & Pain
- Publisher
- Elsevier BV
- Published
- 2009-08
- Volume
- 9
- Issue
- 4
- Pages
- 105-108
- ISSN
- 1472-2615 (ISSN-L)
- 1743-1816
- OpenAlex
- W2132232882
- Cited by
- 168
- References
- 0
- Citations by year
- 2025: 4 · 2024: 4 · 2023: 5 · 2022: 5 · 2021: 5 · 2020: 5 · 2019: 97 · 2018: 9 · 2017: 8 · 2016: 8 · 2015: 4 · 2014: 6 · 2013: 1 · 2012: 4
- FWCI
- 2.36
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Continuing Education in Anaesthesia Critical Care & Pain (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Biomedical and Chemical Research
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Airway Management and Intubation Techniques
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Anesthesia and Sedative Agents
- Keywords
- apnea, preoxygenation, oxygenation, hypoxemia, anesthesia
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