Indian Journal of Anaesthesia  
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Year : 2013  |  Volume : 57  |  Issue : 2  |  Page : 175-179

Techniques of preoxygenation in patients with ineffective face mask seal

Department of Anaesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research Centre, Pondicherry, India

Correspondence Address:
Pankaj Kundra
DII/21, J.I.P.M.E.R Campus, Pondicherry - 605 006
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0019-5049.111847

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Background: Ineffective face mask seal is the most common cause for suboptimal pre-oxygenation. Room air entrainment can be more with vital capacity (VC) breaths when the mask is not a tight fit. Aims: This study was designed to compare 5 min tidal volume (TV) breathing and eight VC breaths in patients with ineffective face mask seal. Methods: Twenty eight ASA I adults with ineffective face mask seal were randomized to breathe 100% oxygen at normal TV for 5 min (Group TV) and eight VC breaths (Group VC) in a cross over manner through circle system at 10 L/min. End tidal oxygen concentration (EtO 2 ) and arterial blood gas analysis was performed to evaluate oxygenation with each technique. Statistical Analysis: Data were analysed using SPSS statistical software, version 16. Friedman's two-way analysis of variance by ranks was used for non-parametric data. Results: Significant increase in EtO 2 (median 90) and PaO 2 (228.85) was seen in group TV when compared to group VC (EtO 2 median 85, PaO 2 147.65), P<0.05. Mean total ventilation volume in 1 min in group VC was 9.4±3.3 L/min and more than fresh gas flow (10 L/min) in seven patients. In group TV, the fresh gas flow (50 L/5 min) was sufficient at normal TV (mean total ventilation in 5 min 36.7±6.3 L/min). Conclusions: TV breathing for 5 min provides better pre-oxygenation in patients with ineffective mask seal with fresh gas flow of 10 L/min delivered through a circle system.

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