title: Time to adequate oxygenation following ventilation using the Enk oxygen flow modulator versus a jet ventilator via needle cricothyrotomy in rabbits.
abstract: BACKGROUND
  Limited information is available on the management of the 'cannot intubate, cannot ventilate' (CICV) situation in infants. We compared the time to achieve adequate oxygenation following rescue ventilation using the Enk oxygen flow modulator (OFM) with a jet ventilator in a simulated CICV situation using the rabbit as an infant respiratory model.
  
  
  METHODS
  Following institutional ethics committee approval, needle cricothyrotomy was performed under direct vision in nine anesthetized rabbits following surgical exposure of the larynx. After ensuring adequate level of anesthesia and analgesia, and confirming proper positioning of the 18G cannula, apnea was induced by the administration of myorelaxant and the SpO2 was allowed to drop to 75% before initiating rescue ventilation via either the OFM or jet ventilator.
  
  
  RESULTS
  Five rabbits were ventilated with the OFM and four with the jet ventilator. Ventilation was maintained with either device for 15 min. All rabbits were successfully rescued using either device. There was no statistical difference in the time required for SpO2 to return to 80%, 85%, 90%, and 95%.
  
  
  CONCLUSIONS
  Both devices facilitated successful rescue ventilation through a needle cricothyrotomy.
authors.affiliation: Department of Anaesthesiology, Queen Mary Hospital, Hong Kong, China.
authors.forename: Carrie F P
authors.initials: CF
authors.lastname: Wong
authors.forename: Vivian M
authors.initials: VM
authors.lastname: Yuen
authors.forename: Gordon T C
authors.initials: GT
authors.lastname: Wong
authors.forename: Jensen
authors.initials: J
authors.lastname: To
authors.forename: Michael G
authors.initials: MG
authors.lastname: Irwin
mesh_terms: D000818:Animals; D001049:Apnea / Q000628:therapy; D001784:Blood Gas Analysis; D001794:Blood Pressure / Q000502:physiology; D002245:Carbon Dioxide / Q000097:blood; D003413:Cricoid Cartilage / Q000601:surgery*; D005240:Feasibility Studies; D006339:Heart Rate / Q000502:physiology; D006611:High-Frequency Jet Ventilation / Q000295:instrumentation / Q000379:methods*; D006863:Hydrogen-Ion Concentration; D000860:Hypoxia / Q000628:therapy; D010100:Oxygen / Q000097:blood*; D011817:Rabbits; D012121:Respiration, Artificial / Q000379:methods*; D013965:Thyroidectomy / Q000379:methods*; D016896:Treatment Outcome; D012122:Ventilators, Mechanical
chemical_list: D002245:Carbon Dioxide; D010100:Oxygen
keywords: animal model; children; difficult airway; infant