Abstract

During preoperative assessment, risk factors of upper airway obstruction should be evaluated: respiratory insufficiency, low O 2 reserve, preoxygenation failure or difficult face mask ventilation. In healthy subjects, spontaneous breathing O 2 for 3 min is the reference method. Apnoea duration is longer after preoxygenation than after denitrogenation, even if FEO 2 and SpO 2 do not change during the two last minutes of preoxygenation. The apnea time is longer after 3 min spontaneous breathing than after four deep breaths for 1 min in most of the literature. Maximal breathing during 2 min can produce values comparable to those obtained with tidal volume breathing for 3 min. FEO 2 monitoring is helpful in the assessment of preoxygenation quality: In case of oxygenation impairment during anaesthesia induction, algorithm use is helpful. Because desperate emergencies will occur in association with anaesthesia, every location should have the immediate availability of Fastrach™ and trans tracheal ventilation. Every anaesthesiologist should be familiar with and well practised in a variety of airway management techniques. Teaching programs are organised in order to develop anaesthesiologist sensitisation and skill.

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