Low-flow transtracheal rescue insufflation of oxygen after profound desaturation.
BACKGROUND
The objective of this study was to determine whether low-flow transtracheal insufflation of oxygen (TRIO) could rescue an animal from profound desaturation. This temporizing maneuver could be useful during cannot-intubate or -ventilate scenarios by resolving hypoxia without the morbidity associated with more invasive procedures.


METHODS
Seven swine for a total of 12 runs were studied. Animals were pharmacologically anesthetized, paralyzed, and mechanically ventilated with room air. After disconnection from the ventilator and desaturation to an Spo2 < 50%, low-flow TRIO (2 L/min) was administered for 1 hour.


RESULTS
All animals survived and Spo2 increased to greater than 90% in 23 seconds on average. Pao2 (mean, 183 mm Hg) remained elevated throughout the study. Hemodynamic stability was maintained for at least 15 minutes.


CONCLUSIONS
Low-flow TRIO rescued animals from profound hypoxia and maintained oxygenation for at least 1 hour. Low-flow TRIO did not prevent hypercarbia with its subsequent sympathetic activation.
Black
Ian H
IH
Walter Reed Army Institute of Research, Silver Spring, Maryland, USA. ian.h.black@us.army.mil
Janus
Scott A
SA
Grathwohl
Kurt W
KW
D000818:Animals; D001049:Apnea / Q000000981:diagnostic imaging / Q000503:physiopathology; D002302:Cardiac Output; D006439:Hemodynamics; D000860:Hypoxia / Q000628:therapy*; D007327:Insufflation / Q000379:methods*; D010100:Oxygen / Q000008:administration & dosage* / Q000097:blood*; D013552:Swine; D014057:Tomography, X-Ray Computed; D014132:Trachea
D010100:Oxygen