Kleine-Brueggeney, Maren; Grosshauser, Mareike; Greif, Robert (2022). Apneic oxygenation in pediatric anesthesia. Current opinion in anaesthesiology, 35(3), pp. 361-366. Wolters Kluwer Health 10.1097/ACO.0000000000001127
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PURPOSE OF REVIEW
Apneic oxygenation is increasingly used in pediatric anesthesia. Its benefit for specific applications depends on the effect of apneic oxygenation on safe apnea time and carbon dioxide (CO2) elimination, on differences between low and high flow oxygen delivery, and on possible adverse effects. The present review summarizes current evidence on these pathophysiological aspects of apneic oxygenation as well as its applications in pediatric anesthesia.
RECENT FINDINGS
Apneic oxygenation with both low flow and high flow nasal oxygen increases the safe apnea time, but does not lead to increased CO2 elimination. Airway pressures and adverse effects like atelectasis formation, oxidative stress and aerosol generation under apneic oxygenation are not well studied in pediatric anesthesia. Data from adults suggest no important effect on airway pressures when the mouth is open, and no significant formation of atelectasis, oxidative stress or aerosol generation with high flow nasal oxygen.
SUMMARY
Apneic oxygenation in pediatric anesthesia is mainly used during standard and difficult airway management. It is sometimes used for airway interventions, but CO2 accumulation remains a major limiting factor in this setting. Reports highlight the use of high flow nasal oxygen in spontaneously breathing rather than in apneic children for airway interventions.
Item Type: |
Journal Article (Review Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic and Policlinic for Anaesthesiology and Pain Therapy |
UniBE Contributor: |
Greif, Robert |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1473-6500 |
Publisher: |
Wolters Kluwer Health |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
08 Jun 2022 10:59 |
Last Modified: |
02 Jul 2023 00:25 |
Publisher DOI: |
10.1097/ACO.0000000000001127 |
PubMed ID: |
35671025 |
BORIS DOI: |
10.48350/170502 |
URI: |
https://boris.unibe.ch/id/eprint/170502 |
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