title: The effect of age and increasing head-up tilt on pre-oxygenation times in children: a randomised exploratory study.
abstract: We conducted a randomised exploratory trial in children aged between one and sixteen years old to establish the time to achieve an end-tidal oxygen fraction ≥ 0.9 in three different positions: supine, and 30 and 45° head up. We recruited 120 children analysed in two age groups: 1-8 years and 9-16 years. The median (IQR [range]) time to reach the end point was 80 (59-114 [41-295]) s in the younger group and 150 (107-211 [44-405]) s in the older group, regardless of position (p = 0.0001). The end point was reached in 90% of children in approximately 160 s in the younger, and 271 s in the older, groups, respectively. There was no statistical difference between the three positions within each age group in the time to reach the endpoint (p = 0.59). Only two patients in the older age group could not reach the end point, due to poorly fitting facemasks. We conclude that pre-oxygenation can therefore be achieved effectively in most children, and that tilting children head up by 30 or 45° does not significantly reduce the time taken to achieve an end-tidal oxygen fraction of ≥ 0.9. The recommended period for pre-oxygenation in both groups should remain at 3 min but it should be noted that this may be insufficient for many older patients.
authors: Royal Manchester Children's Hospital, Manchester, UK.
authors: V
authors: V
authors: Oshan
authors: Royal Manchester Children's Hospital, Manchester, UK.
authors: N
authors: N
authors: Plant
authors: Royal Manchester Children's Hospital, Manchester, UK.
authors: P
authors: P
authors: Gopal
authors: Department of Research and Innovation, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.
authors: A
authors: A
authors: Rajai
authors: Centre for Biostatistics, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK.
authors: S A
authors: SA
authors: Roberts
authors: Royal Manchester Children's Hospital, Manchester, UK.
authors: R W M
authors: RW
authors: Walker
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D006801:Humans; D000860:Hypoxia / Q000517:prevention & control*; D007223:Infant; D010100:Oxygen / Q000008:administration & dosage*; D011187:Posture / Q000502:physiology*; D012119:Respiration; D016683:Supine Position; D013997:Time Factors
chemical_list: D010100:Oxygen