The effect of CPAP during preoxygenation and PEEP during induction upon the duration of non-hypoxic apnea and hemodynamic parameters
Keywords:CPAP, PEEP, Non-hypoxic apnea, Preoxygenation
Aim: This study evaluated the effects of applying CPAP during preoxygenation and PEEP during mask ventilation upon the duration of non-hypoxic apnea and hemodynamic parameters.
Methods: This prospective randomized study included 100 patients allocated to 4 groups. In Groups I and III, preoxygenation was applied with CPAP mask without any pressure and during induction ventilation was performed with volume-controlled ventilation (CMV) in Group I and CMV + 6 cm H2O PEEP in Group III. In Groups II and IV, preoxygenation was applied with CPAP mask with 6 cmH2O pressure and during induction; ventilation was performed with CMV in Group II and CMV + 6 cm H2O PEEP in Group IV. After tracheal intubation, the tube was left open to air and the patient remained apneic until SpO2 reached 90%.
Results: The time for SpO2 to reach 90% is significantly longer in Group IV compared to the other groups. The durations were 412.50±97.37 sec in Group I, 443.52±88.84 sec in Group II, 415.20±117.45 sec in Group III and 522.92±83.44 sec in Group IV. Using only CPAP during preoxygenation and only PEEP during mask ventilation had no significant effect on duration of non-hypoxic apnea.
Conclusion: Especially for patients with difficult intubation, application of CPAP during preoxygenation followed with PEEP during mask ventilation safe, simple and it prolongs non-hypoxic apnea period.
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