Anestéziológia a intenzívna medicína 2/2017

Apneic oxygenation and its use during intubation

Endotracheal intubation is a routine procedure which can very quickly escalate into a life threatening situation. The time required to solve this problem while a patient is not breathing or can’t be ventilated is limited by the body oxygen stores. The rate of haemoglobin desaturation during apnea varies depending on a presence of risk factors. Apneic oxygenation can provide O2 to alveoli without ventilation relying on a flow created by a volume difference between absorbed O2(250 ml/min) and CO2 excreted into alveoli (10 ml/min). Ideally, it can cover 90% of oxygen demand every minute. Basic requirements for an effective apneic oxygenation are preoxygenation, airway patency and the continuous provision of 100% oxygen into the airways. Effectivity of apneic oxygenation is limited by an airway obstruction and an alveolar collapse. It appears that apneic oxygenation has a potential to increase safety during endotracheal intubation in a selected patient population.

Keywords: apneic oxygenation, haemoglobin desaturation, preoxygenation