title: A dual-use laryngoscope to facilitate apneic oxygenation.
abstract: BACKGROUND
  In preoxygenated patients, time until oxygen saturation drops can be extended by insufflating oxygen into their airways, thus oxygenating them apneically.
  
  
  OBJECTIVE
  To compare different methods of apneic oxygenation.
  
  
  METHODS
  A noncommercial dual-use laryngoscope with an internal lumen in its blade was used to provide oxygen insufflation into a simulated laryngeal space during intubation. In this experimental study, oxygen insufflation via the dual-use laryngoscope was compared with no oxygen insufflation, with nasal oxygen insufflation, and with direct intratracheal oxygen insufflation. In a preoxygenated test lung of a manikin, oxygen percentage decrease was measured over a 20-min observation period for each method of oxygen application.
  
  
  RESULTS
  Oxygen percentage in the test lung dropped from 97% to 37 ± 1% in the control group (p < 0.001 compared to all other groups) and to 68 ± 1% in the nasal insufflation group (p < 0.001 compared to all other groups). Oxygen percentage remained over 90% in both the direct intratracheal insufflation group (96 ± 0%) and the laryngoscope blade insufflation group (94 ± 1%) (p < 0.01 between the latter two groups).
  
  
  CONCLUSIONS
  Simulating apneic oxygenation in a preoxygenated manikin, deep laryngeal oxygen insufflation via the dual-use laryngoscope kept oxygen percentage in the test lung above 90%, and was more effective than oxygen insufflation via nasal prongs.
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Thomas
authors.initials: T
authors.lastname: Mitterlechner
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, University Hospital of Cologne, Cologne, Germany.
authors.forename: Holger
authors.initials: H
authors.lastname: Herff
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Christian W
authors.initials: CW
authors.lastname: Hammel
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Patrick
authors.initials: P
authors.lastname: Braun
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Peter
authors.initials: P
authors.lastname: Paal
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Volker
authors.initials: V
authors.lastname: Wenzel
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Arnulf
authors.initials: A
authors.lastname: Benzer
mesh_terms: D001049:Apnea / Q000628:therapy*; D006801:Humans; D007327:Insufflation / Q000295:instrumentation* / Q000379:methods; D007442:Intubation, Intratracheal / Q000295:instrumentation* / Q000379:methods; D020704:Laryngoscopes; D008168:Lung / Q000378:metabolism; D008348:Manikins; D010100:Oxygen / Q000008:administration & dosage* / Q000493:pharmacokinetics
chemical_list: D010100:Oxygen
keywords: airway; apneic oxygenation; insufflation; laryngoscope