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Comparison of preoxygenation efficacy between continuous positive airway pressure (CPAP) mode and conventional mode during induction of general anesthesia
Received:April 02, 2022  Revised:May 20, 2022  Click here to download the full text
Citation of this paper:SONG Yue-jiao,YANG Zhen,LIANG Ying-hua,DING Ming,GE Sheng-jing,LIAO Qing-wu.Comparison of preoxygenation efficacy between continuous positive airway pressure (CPAP) mode and conventional mode during induction of general anesthesia[J].Chinese Journal of Clinical Medicine,2022,29(5):789-794
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Author NameAffiliationE-mail
SONG Yue-jiao Department of Anesthesia, Zhongshan Hospital (Xiamen Branch), Fudan University, Xiamen 361015, Fujian, China  
YANG Zhen Department of Anesthesia, Zhongshan Hospital (Xiamen Branch), Fudan University, Xiamen 361015, Fujian, China  
LIANG Ying-hua Department of Anesthesia, Zhongshan Hospital (Xiamen Branch), Fudan University, Xiamen 361015, Fujian, China  
DING Ming Department of Anesthesia, Zhongshan Hospital, Fudan University, Shanghai 200032, China ding.ming@zs-hospital.sh.cn 
GE Sheng-jing Department of Anesthesia, Zhongshan Hospital, Fudan University, Shanghai 200032, China  
LIAO Qing-wu Department of Anesthesia, Zhongshan Hospital, Fudan University, Shanghai 200032, China liao.qingwu@zs-hospital.sh.cn 
Abstract:Objective To compare the preoxygenation efficacy of continuous positive airway pressure (CPAP) mode and conventional mode during induction of general anesthesia. Methods From May 1st, 2020 to December 31st, 2021, 81 patients who were treated in Zhongshan Hospital (Xiamen Branch), Fudan University were included, they were divided into spontaneous breathing group before induction (n=27), pressure support assisted ventilation PSV group after induction (n=26), and CPAP group before induction (n=28). To compare the time for fraction of expirated oxygen (FeO2) to reach 90%; FeO2, arterial blood oxygen partial pressure (PaO2), carbon dioxide partial pressure (PaCO2) in 4 min without ventilation; incidence of reflux during intubation; hemodynamic changes. Results The time required for FeO2 to reach 90% in the CPAP group was shorter than that in the spontaneous breathing group (P=0.01), and there was no significant difference compared with the PSV group. Cox proportional-hazard regression analysis showed that the time required to reach 90% FeO2 in the three groups was not significantly correlated with gender, age, and BMI. Compared with the spontaneous breathing mode, the CPAP mode was HR=0.430 (95%CI 0.243-0.761; P=0.04); compared with PSV mode, the CPAP mode was HR=0.810 (95%CI 0.474-1.383; P=0.44). The PaCO2 in the CPAP group was lower than that in the spontaneous breathing group at 4 minutes without ventilation (P=0.03), and there was no significant difference compared with the PSV group. There was no significant difference in the hemodynamic changes before and after intubation. Conclusion CPAP mode of pre-oxygenation before induction of general anesthesia is more effective than the spontaneous breathing mode before induction, the time required is shorter, and the PaCO2 is lower in the 4-min non-ventilation state.
keywords:continuous positive airway pressure  pre-oxygenation  efficacy
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