Standard preoxygenation vs two techniques in children.
BACKGROUND
Preoxygenation is recommended in pediatric anesthesia but it has been poorly assessed. Fractional expired oxygen concentration (F(ET)O(2)) is a preoxygenation monitor. The aim of this prospective study in children was to compare three techniques of preoxygenation by the measurement of F(ET)O(2).


METHODS
Twenty children (6-15 years) were included. F(ET)O(2) was measured with the child in a supine position, holding the face mask. The F(ET)O(2) value was measured after 3 min of calm breathing of room air (baseline) and during the three preoxygenation techniques performed in random order: 3 min of tidal volume breathing using an O(2) flow of 9 l x min(-1) (TV x 3 min)--four deep breaths within 30 s using an O(2) flow of 15 l x min(-1) (4 DB)--eight deep breaths within 1 min using an O(2) flow of 15 l x min(-1) (8 DB). Between each technique, at least 5 min breathing room air was allowed to return to baseline F(ET)O(2). Fisher's exact test was used and P < 0.05 was considered significant.


RESULTS
Twenty children were studied (age: 11.5 +/- 3 years, weight: 42 +/- 21 kg). The F(ET)O(2) > or = 90% was found to be 79% in 74 +/- 40 s with TV x 3 min, 11% with 4 DB, and 68% with 8 DB.


CONCLUSIONS
In children, Vt x 3 min is the most efficient preoxygenation technique to reach F(ET)O(2) > or = 90%.
Chiron
Bruno
B
Service d'Anesthésie-Réanimation, Centre Pédiatrique Gatien-de-Clocheville CHRU de Tours, Tours, France. b.chiron@voila.fr
Mas
Christophe
C
Ferrandière
Martine
M
Bonnard
Christian
C
Fusciardi
Jacques
J
Mercier
Colette
C
Laffon
Marc
M
D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D010100:Oxygen / Q000008:administration & dosage* / Q000378:metabolism; D011300:Preoperative Care; D011446:Prospective Studies; D013990:Tidal Volume
D010100:Oxygen