Abstract
Critically ill patients requiring emergent endotracheal intubation are at risk for life-threatening hypoxemia during the intubation procedure, particularly when the patient is apneic and not receiving any supplemental oxygen. In a current study, Engström and colleagues investigated the effect of nasopharyngeal oxygenation in eight anesthetized pigs with induced acute lung injury. The investigators confirmed, even in this model, that pharyngeal oxygenation significantly prolonged the time to desaturation during periods of apnea. Recognizing the limitations of directly extrapolating these experimental results to critically ill human subjects, the findings do support the contention that, until proven otherwise, nasopharyngeal oxygenation should at least be considered as one technique to diminish hypoxemic complications in very sick patients, particularly those with underlying pulmonary impairment.
Highlights
Ill patients requiring emergent endotracheal intubation are at risk for life-threatening hypoxemia during the intubation procedure, when the patient is apneic and not receiving any supplemental oxygen
*Correspondence: Lynn.Roppolo@UTSouthwestern.edu 1Emergency Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Mail Code 8579, Dallas, TX 75390-8579, USA Full list of author information is available at the end of the article
The specific premise of the current investigation by Engström and colleagues was to use an animal model involving induced acute lung injury in order to demonstrate that even in underlying conditions at greater risk for life-threatening hypoxemia, the oxygen desaturation can be minimized by using the pharyngeal catheter supplemental oxygen technique
Summary
Ill patients requiring emergent endotracheal intubation are at risk for life-threatening hypoxemia during the intubation procedure, when the patient is apneic and not receiving any supplemental oxygen. The prospective investigation by Engström and colleagues in a previous issue of Critical Care sets out to determine if apneic oxygenation via a pharyngeal catheter during endotracheal intubation would prevent or increase the time to life-threatening hypoxemia in an animal model with acute lung injury [1].
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