Document Detail


Usefulness of continuous oxygen insufflation into trachea for management of upper airway obstruction during anesthesia.
MedLine Citation:
PMID:  10861147     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Severe complications associated with upper airway obstruction often occur during the perioperative period. Development of a simple and reliable technique for reversing the impaired airway patency may improve airway management. The purpose of the current study is to evaluate the usefulness of transtracheal oxygen insufflation (TTI) for management of upper airway obstruction during anesthesia and to explore the mechanisms of TTI in detail. METHODS: During propofol anesthesia in eight spontaneously breathing patients, the upper airway cross-sectional area and pressure-flow measurements during neck flexion with TTI were compared with those during triple airway maneuvers (TAM) without TTI. Blood gas analyses assessed efficacy of CO2 elimination during TTI in an additional nine patients. RESULTS: TTI achieved adequate PaCO2 and PaO2 levels equivalent to those during TAM. In addition to a significantly smaller cross-sectional area during TTI, the location and slope of the pressure-flow relation during TTI completely differed from those during TAM, indicating that upper airway resistance was much higher during TTI. Notably, minute ventilation during TTI was significantly smaller than that during TAM, suggesting reduced dead space or other mechanisms for CO2 elimination. CONCLUSIONS: TTI is capable of maintaining adequate blood gases through mechanisms different from those of conventional airway support in anesthetized subjects with upper airway obstruction.
Authors:
J Okazaki; S Isono; A Tanaka; Y Tagaito; A R Schwartz; T Nishino
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Anesthesiology     Volume:  93     ISSN:  0003-3022     ISO Abbreviation:  Anesthesiology     Publication Date:  2000 Jul 
Date Detail:
Created Date:  2000-08-07     Completed Date:  2000-08-07     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  1300217     Medline TA:  Anesthesiology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  62-8     Citation Subset:  AIM; IM    
Affiliation:
Chiba University School of Medicine, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Airway Obstruction / therapy*
Anesthesia, General*
Anesthetics, Intravenous
Animals
Blood Gas Analysis
Humans
Insufflation
Intraoperative Complications / therapy*
Middle Aged
Oxygen / administration & dosage*,  therapeutic use
Propofol
Trachea
Chemical
Reg. No./Substance:
0/Anesthetics, Intravenous; 2078-54-8/Propofol; 7782-44-7/Oxygen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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