In this episode, we are joined by Tyler Christifulli of the FOAMfrat blog and podcast (formally Lifestar Podcast), and FlightBridgeEd. Apneic oxygenation has been recently popularized for use during RSI in an attempt to decrease desaturation time during the apneic period of induction. Inspired by a discussion between Tyler and Dr. Jeff Jarvis, we decided to collaborate in testing the inspired O2 capabilities of several commonly used nasal cannulas with this purpose in mind. You may be surprised by our results. Tune in as we briefly discuss the physiological process of apneic oxygenation, and the equipment you should and should not be using for supplementation.
Video:
Christifulli, T. (2017, May 19). Episode 20: Tips for the occassional intubator Part 2. Retrieved January 5, 2018, from FOAMfrat Podcast: https://soundcloud.com/user-35752175/podcast-20-tips-for-the-occasional-intubator-part-2
MW, S., DR, J., RJ, L., DT, M., BC, N., TR, A., et al. (2016, February 1). Randomized trial of apneic oxygenation during endotracheal intubation of the critically ill. American Jouranal Respirartory Critical Care Medicine , pp. 273-280.
Pavlov, I., Medrano, S., & Weingart, S. (2017, August). Apneic oxygenation reduces the incidence of hypoxemia during emergency intubation: A systematic review and meta-analysis. Americal Journal of Emergency Medicine, pp. 1184-1189.
I know that this is just for experimental purposes, but don’t the end tidal capnography cannulas have a 5-6 lpm limit? I am curious to see how much O2 is delivered at those rates. Great video!
Are you questioning the difference between an ETCO2 cannula at 6LPM versus a regular cannula at the same flow rate? The biggest issue is that O2 is not delivered though the nasal prongs. Thus, without active inhalation, it does not contribute to passive oxygenation.