Comparison of the efficacy of two preoxygenation techniques using oxygen reserve index.

IF 2.1 4区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Advances in Clinical and Experimental Medicine Pub Date : 2024-09-09 DOI:10.17219/acem/188259
Yesim Cokay Abut, Ece Kisa
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Abstract

Background: Preoxygenation is very important to protect the patient from hypoxia before intubation. However, pulse oximetry has some limitations in detecting hypoxia.

Objectives: We aimed to compare the effectiveness of 2 preoxygenation techniques based on oxygen reserve index (ORI) levels.

Material and methods: Twenty healthy male volunteers were included in the study. They inhaled 100% FiO2 oxygen administered at 5 L/min as the 1st technique (M1) with a ventilation mask as much as their tidal volumes for 3 min. The 2nd technique (M2) applied 100% FiO2 oxygen at 10 L/min flow using the same mask and 8 deep inspiratory volumes, which was aimed to be completed within 1 min. Maximum ORI levels, duration to reach that level, and time needed to reach the target ORI level (0.35) and return back to the "0" were measured.

Results: In the M1 group, ORI levels were significantly higher during and after 60 s, according to post hoc tests. In the M2 groups, ORI levels were significantly higher during and after the 4th inspiration, according to post hoc tests. Oxygen reserve index values at the 60th 2nd (M1) and 8th inspiration (M2) were compared as the 8th inspiration corresponded to the 60th second. The maximum ORI values were significantly lower in the M1 group compared to the M2 group (p < 0.001 and p = 0.006, respectively). Seven volunteers (36.8%) in the M1 group and 2 volunteers (10.5%) in the M2 group could not reach the target ORI (McNemar's test, test statistic 3.2, degrees of freedom (df) = 1, p = 0.063). The time to reach the target ORI value and to reach maximum ORI values was significantly longer in the M1 group than in the M2 group (p = 0.008 and p < 0.001, respectively).

Conclusions: We observed that the 8-deep breath technique is more effective in preoxygenation compared to the 3-min tidal volume technique.

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利用氧储备指数比较两种预氧技术的功效。
背景:预吸氧对于保护患者在插管前避免缺氧非常重要。然而,脉搏血氧仪在检测缺氧方面存在一些局限性:我们旨在比较两种基于氧储备指数(ORI)水平的预吸氧技术的有效性:研究对象包括 20 名健康男性志愿者。作为第一种技术(M1),他们使用通气面罩以 5 L/min 的速度吸入与潮气量相当的 100% FiO2 氧气,持续 3 分钟。第 2 种技术(M2)使用相同的面罩和 8 次深吸气量,以 10 L/min 的流量吸入 100% FiO2 氧气,目标是在 1 分钟内完成。测量了最大 ORI 水平、达到该水平的持续时间以及达到目标 ORI 水平(0.35)并恢复到 "0 "所需的时间:结果:根据事后检验,M1 组的 ORI 水平在 60 秒内和 60 秒后明显较高。经事后检验,M2 组在第 4 次吸气时和吸气后的 ORI 水平明显更高。由于第 8 次吸气相当于第 60 秒,因此比较了第 60 秒(M1)和第 8 次吸气(M2)时的氧储备指数值。与 M2 组相比,M1 组的最大氧储备指数值明显较低(分别为 p < 0.001 和 p = 0.006)。M1 组有 7 名志愿者(36.8%)和 M2 组有 2 名志愿者(10.5%)无法达到目标 ORI(McNemar 检验,检验统计量 3.2,自由度(df)= 1,p = 0.063)。M1 组达到目标 ORI 值和达到最大 ORI 值的时间明显长于 M2 组(分别为 p = 0.008 和 p <0.001):我们观察到,与 3 分钟潮气量技术相比,8 次深呼吸技术对预吸氧更有效。
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来源期刊
Advances in Clinical and Experimental Medicine
Advances in Clinical and Experimental Medicine MEDICINE, RESEARCH & EXPERIMENTAL-
CiteScore
3.70
自引率
4.80%
发文量
153
审稿时长
6-12 weeks
期刊介绍: Advances in Clinical and Experimental Medicine has been published by the Wroclaw Medical University since 1992. Establishing the medical journal was the idea of Prof. Bogumił Halawa, Chair of the Department of Cardiology, and was fully supported by the Rector of Wroclaw Medical University, Prof. Zbigniew Knapik. Prof. Halawa was also the first editor-in-chief, between 1992-1997. The journal, then entitled "Postępy Medycyny Klinicznej i Doświadczalnej", appeared quarterly. Prof. Leszek Paradowski was editor-in-chief from 1997-1999. In 1998 he initiated alterations in the profile and cover design of the journal which were accepted by the Editorial Board. The title was changed to Advances in Clinical and Experimental Medicine. Articles in English were welcomed. A number of outstanding representatives of medical science from Poland and abroad were invited to participate in the newly established International Editorial Staff. Prof. Antonina Harłozińska-Szmyrka was editor-in-chief in years 2000-2005, in years 2006-2007 once again prof. Leszek Paradowski and prof. Maria Podolak-Dawidziak was editor-in-chief in years 2008-2016. Since 2017 the editor-in chief is prof. Maciej Bagłaj. Since July 2005, original papers have been published only in English. Case reports are no longer accepted. The manuscripts are reviewed by two independent reviewers and a statistical reviewer, and English texts are proofread by a native speaker. The journal has been indexed in several databases: Scopus, Ulrich’sTM International Periodicals Directory, Index Copernicus and since 2007 in Thomson Reuters databases: Science Citation Index Expanded i Journal Citation Reports/Science Edition. In 2010 the journal obtained Impact Factor which is now 1.179 pts. Articles published in the journal are worth 15 points among Polish journals according to the Polish Committee for Scientific Research and 169.43 points according to the Index Copernicus. Since November 7, 2012, Advances in Clinical and Experimental Medicine has been indexed and included in National Library of Medicine’s MEDLINE database. English abstracts printed in the journal are included and searchable using PubMed http://www.ncbi.nlm.nih.gov/pubmed.
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