Effect of high-flow nasal oxygen use on oxygen flow at the surgical site: a pilot study

Abstract

Editor—High-flow nasal oxygen (HFNO) has originally been used for neonates and has recently gained attention for its potential role in critical care and anaesthesia for adult patients. 1 Renda T. Corrado A. Iskandar G. et al. High-flow nasal oxygen therapy in intensive care and anaesthesia. Br J Anaesth. 2018; 120: 18-27 Abstract Full Text Full Text PDF PubMed Scopus (71) Google Scholar , 2 Carullo P.C. Phillips D.P. Abuelkasem E. Hilmi I.A. The perioperative application of high flow nasal cannula: a single center experience. J Anesth Crit Care Open Access. 2020; 12: 15 Google Scholar , 3 Deguchi Y. Seki H. Tamaki H. Ouchi T. Successful airway and anesthesia management using a high-flow nasal cannula in a fibrodysplasia ossificans progressiva patient during general anesthesia: a case report. A A Pract. 2020; 14: 75-78 Crossref PubMed Scopus (3) Google Scholar , 4 Burbridge M.A. Brodt J. Jaffe R.A. Ventriculoperitoneal shunt insertion under monitored anesthesia care in a patient with severe pulmonary hypertension. A A Case Rep. 2016; 7: 27-29 Crossref PubMed Scopus (4) Google Scholar HFNO improves oxygenation in patients with obesity or diminished respiratory function by delivering high flow and concentration oxygen. Although a closed claims analysis has shown that ‘low-flow’ oxygen delivery devices, such as face masks and nasal cannulae, rarely contribute to surgical fires when surgical sites are distant from oxygen delivery devices, 5 Mehta S.P. Bhananker S.M. Posner K.L. Domino K.B. Operating room fires: a closed claims analysis. Anesthesiology. 2013; 118: 1133-1139 Crossref PubMed Scopus (59) Google Scholar it is unclear whether high-flow oxygen delivered using HFNO increases local oxygen concentration at surgical sites, thereby increasing the risk of surgical fire. Because the intraoperative use of HFNO is expected to increase, 6 Cooper J. Griffiths B. Ehrenwerth J. Safe use of high-flow nasal oxygen (HFNO) with special reference to difficult airway management and fire risk. vol. 33. Anesthesia Patient Safety Foundation Newsletter, 2018https://www.apsf.org/article/safe-use-of-high-flow-nasal-oxygen-hfno-with-special-reference-to-difficult-airway-management-and-fire-risk/Date accessed: May 30, 2021 Google Scholar it is necessary to understand its impact on oxygen concentration at surgical sites distant from HFNO delivery. This pilot study aimed to investigate the effects of HFNO on oxygen flow to surgical sites below the chest.