Related Experiment Video
Updated: May 10, 2026

Preoxygenation Techniques for Tracheal Intubation in Critically Ill Adults Utilizing Oxygen Mask and Noninvasive Ventilation
Published on: December 5, 2025
Techniques of preoxygenation in patients with ineffective face mask seal
Pankaj Kundra1, Shirley Stephen, Stalin Vinayagam
1Department of Anaesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research Centre, Pondicherry, India.
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 (EtO2) and arterial blood gas analysis was performed to evaluate oxygenation with each technique.
Statistical And 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 EtO2 (median 90) and PaO2 (228.85) was seen in group TV when compared to group VC (EtO2 median 85, PaO2 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.
Related Concept Videos
Administering Oxygen by Mask
Administering oxygen by mask is a common nursing intervention that provides supplemental oxygen to patients with respiratory distress or chronic lung conditions. This procedure involves delivering oxygen at a specified rate through a face mask connected to an oxygen source.
Equipment
The equipment necessary for this procedure includes:
Cardiopulmonary Resuscitation II: ACLS Airway Management
Oxygen Delivering System I: Nasal Cannula and Face Mask
Nasal Cannula
A nasal cannula is a lightweight tube split at one end into two prongs and placed in the nostrils. It is typically used to deliver low to medium levels of oxygen.
Suggested flow rate: The suggested flow rate for a nasal cannula typically ranges between 1 and 6 L/min.
Oxygen percentage setting:...
Oxygen Delivering System II: Venturi Mask and Transtracheal Oxygen
Venturi Mask
The Venturi mask, named after the Venturi effect, is designed to deliver precise oxygen concentrations. It consists of a large tube with an oxygen inlet that narrows down, causing a pressure drop that pulls air in through adjustable side ports. The mask is a lightweight,...
Administering Oxygen by Nasal Cannula
Nasal Cannulas
A nasal cannula is a lightweight tube split into two prongs placed in the nostrils, connected...
Tracheostomy Care II: Procedure
Step 1: Perform hand hygiene, and put on personal protective equipment: gown, gloves, mask and...

