Safe apnea time

Description

The principal objective of airway management during anesthesia is maintenance of oxygenation. As the patient transitions from wakefulness to anesthesia and receives neuromuscular blockade, the anesthetist is afforded a finite time (‘apneic window’) during which to secure a definitive airway. Failure to do so normally results in recommencement of facemask ventilation, re-oxygenation and a further attempt at securing a definitive airway. In some patients, the combination of unfavorable pharyngolaryngeal anatomy and reduced apnea time due to cardiorespiratory decompensation makes this stop-start approach hazardous. Hence it is prudent to preoxygenate and increase physiological stores of oxygen in order to prolong the time to desaturation during a period of apnea (safe apnea time), which frequently happens upon induction of anesthesia, sometimes during post extubation. This is particularly the case during a rapid sequence induction, when positive pressure ventilation is avoided prior to intubation of the trachea.This presentation deals with all aspect of safe apnea management.