Comparison Between Tidal Volume and Vital Capacity Breathing Techniques of Preoxygenation in Patients with Ineffective Facemask Seal

Objective: The purpose of this research was to compare the mean hemoglobin oxygen de-saturation time by using tidal volume breathing technique for three minutes and eight vital capacity breathing technique for pre- oxygenation in patients with ineffective face mask seal. Methods: This study included 60 patients with beard, moustache, large nasal bridge, facial anomalies, nasogastric tube and edentulous patients. They were randomized into 2 groups after achieving documented informed consent. Group-A was preoxygenated with TV breathing technique for three minutes at an oxygen flow of 10 litres per minute. Whereas, Group-B was preoxygenated with eight VC breaths for one minute at an oxygen flow of 10 litres per minute. Results: The age of the participants varied from 22 years to 65 years with an average of 44.63±10.03 years. There were 29(48.3%) male and 31(51.7%) female patients in the research group. Both the groups were comparable in respect of mean age (p=0.839) and gender distribution (p=0.796). The mean hemoglobin oxygen desaturation time was considerably longer in VC breathing group (6.77±1.10 vs. 3.43±.50 minutes; p=0.000) in contrast to TV breathing group regardless of age and gender of patients. Conclusion: The mean hemoglobin oxygen desaturation time was substancially longer in vital capacity breathing group (6.77±1.10 vs. 3.43±.50 minutes; p=0.000) in contrast to tidal volume breathing group regardless of patient's age and gender in patients with ineffective face mask seal undergoing elective surgery. Key Words: Ineffective Face Mask Seal, Preoxygenation Breathing Techniques, Vital Capacity, Tidal Volume, Mean Hemoglobin Oxygen Desaturation Time How to Cite: Arshad F. Nabi H, Sohail F, Anwar A, Aijaz B,Butt Z. Comparison between tidal volume and vital capacity breathing techniques of preoxygenation in patients with ineffective face mask seal. Esculapio.2020;16(04):46-49.

Comparison of the Single Breath Vital Capacity Technique with the Tidal Volume Technique

Introduction: The single breath vital capacity (VC) induction and the tidal volume (TV) breathing induction are currently administered for inhalation of anaesthesia with sevoflurane in children. The aim of this study was to determine whether the vital capacity technique achieves more rapid induction of anaesthesia in children compared to the conventional tidal volume technique. Material and Methods: Sixty ASA physical status 1 or 2 children aged between 5 and 15 years, scheduled to undergo elective urological, orthopaedic or visceral surgery under general anaesthesia using inhalational induction with sevoflurane were recruited and randomized to receive either vital capacity induction or tidal volume induction with 8% sevoflurane at 6L/min of O2 followed by laryngeal mask airway insertion or endotracheal intubation with endotracheal tube. Time required for induction, hemodynamic changes, airway tolerance, side-effects, level of satisfaction using a visual analogue scale (0-100) and Smiley scale (0-10) were documented. Results: Induction time was significantly shorter with the vital capacity induction technique than with the tidal volume breathing induction technique (43.8 ± 13.4 seconds vs 70.8 ± 16.4 seconds; P<0.01). The time to central myosis, haemodynamic changes and respiratory events incidences were similar in both the group. Fewer complications occurred with vital capacity group. More than 94% of the children choose the single Breath Vital Capacity method of induction to the tidal volume technique. Conclusion: For inhalation induction of anaesthesia, the vital capacity induction was faster and produced less complication than that of tidal volume breathing technique.

Lipoabdominoplasty: repercussions for diaphragmatic mobility and lung function in healthy women

ABSTRACT Objective: To evaluate the impact of lipoabdominoplasty on diaphragmatic mobility (DM) and lung function in healthy women. Methods: This was a prospective cohort study using high-resolution ultrasound and forced spirometry to assess DM and lung function, respectively, prior to lipoabdominoplasty, as well as on postoperative day (POD) 10 and POD 30. DM was measured under two conditions: during tidal volume breathing and during a VC maneuver. Results: The sample consisted of 20 women, with a mean age of 39.85 ± 7.52 years and a mean body mass index of 26.21 ± 2.0 kg/m2. Comparing the preoperative and postoperative periods, we found that DM and lung function values were significantly lower after lipoabdominoplasty, the mean DM on POD 10 being 17% and 15% lower during tidal volume breathing and during the VC maneuver, respectively, in comparison with the preoperative mean (p = 0.009 and p < 0.001, respectively). In addition, FEV1, FVC, and PEF were significantly lower on POD 10 than in the preoperative period (p = 0.046, p = 0.002, and p < 0.001, respectively), returning to preoperative values by POD 30. Conclusions: Lipoabdominoplasty appears to have negative short-term repercussions for DM and lung function in healthy women. However, lung function and DM are both apparently restored to preoperative conditions by POD 30. (ClinicalTrials.gov identifier: NCT02762526 [http://www.clinicaltrials.gov/])