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Apneic oxygenation in pediatric anesthesia.
Maren Kleine-Brueggeney1, Mareike Grosshauser2, Robert Greif3,4
1Department of Anaesthesia, University Children's Hospital Zurich - Eleonore Foundation, Zurich.
Current Opinion in Anaesthesiology
|June 7, 2022
Summary
Apneic oxygenation in pediatric anesthesia extends safe apnea time but does not improve carbon dioxide elimination. Further research is needed on airway pressures and adverse effects in children.
Area of Science:
- Pediatric Anesthesiology
- Respiratory Physiology
Background:
- Apneic oxygenation is a common technique in pediatric anesthesia.
- Understanding its effects on safe apnea time, CO2 elimination, and safety is crucial.
Purpose of the Study:
- To review current evidence on the pathophysiological aspects of apneic oxygenation in pediatric anesthesia.
- To evaluate its impact on safe apnea time, CO2 elimination, and potential adverse effects.
Main Methods:
- Literature review of studies on apneic oxygenation in pediatric anesthesia.
- Analysis of data on low vs. high flow oxygen delivery.
- Examination of effects on airway pressures and adverse events.
Main Results:
- Apneic oxygenation increases safe apnea time with both low and high flow oxygen.
- It does not enhance carbon dioxide elimination.
- Adverse effects like atelectasis and oxidative stress are not well-studied in pediatric patients.
Conclusions:
- Apneic oxygenation is primarily used for airway management in pediatric anesthesia.
- Carbon dioxide accumulation is a significant limitation.
- High flow nasal oxygen is more frequently used in spontaneously breathing children for airway interventions.
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