NHFO AS PERIANAESTHETIC OXYGENATION ALTERNATIVE
Research type
Research Study
Full title
Nasal High Flow Oxygen As An Alternative For Peri Anaesthetic Oxygen Therapy and Respiratory Support
IRAS ID
142921
Contact name
THALIA MONRO-SOMERVILLE
Contact email
Sponsor organisation
R and D NHS Lanarkshire
Research summary
We aim to show that the use of nasal high flow oxygen (NHFO) is a safe and reliable alternative to the standard anaesthetic mask for maintaining oxygenation before, during and after standard anaesthetic treatment.
In anaesthesia preoxygenation is used to concentrate oxygen in the lungs by washing out nitrogen and increasing the functional residual capacity (FRC) of the patient allowing for a greater oxygen reserve and delay in desaturation (drop in oxygen levels)during instrumentation of the airway. Preoxygenation is carried out by firmly holding a clear plastic facemask with a soft inflatable seal to the patient’s face for between 1 and 3 minutes prior to to inducing anaesthesia allowing oxygen to concentrate in the lungs washing out other airway gases like nitrogen.
Patients often find the mask claustrophobic. In a patient breathing gently and without respiratory compromise, their peak inspiratory flow rate should be approximately 30l/min which is adequately provided by the NHFO devices which have a peak inspiratory flow delivery of 60L/min, in addition to providing an element of posiitve airway pressure, which helps to keep the airways open. Patient compliance with the therapy should be better and comfort greater. Furthermore, following induction of anaesthesia, the source of oxygen would not need to be removed whilst instrumenting the airway and should manual ventilation be required the mask can be placed over the nasal cannulae.
When the operation is finished and the patient is being woken up, the NHFO can be replaced prior to removal of any airway devices so that the first unsupported patient breath is oxygen rich, helps splint open the airways and is warm and humidified.
This oxygen delivery system can then be transported with the patient during their transfer to the recovery area, and then on to the wards where it can continue to be used.REC name
West of Scotland REC 4
REC reference
14/WS/1037
Date of REC Opinion
10 Jul 2014
REC opinion
Unfavourable Opinion