Effect of Obesity on the Time Required Achieving a FEO2 of 90% during Preoxygenation
Roya Yumul1, Ofelia L. Elvir-Lazo2, Xuezhao Cao3, Paul F. White4*, Jun Tang2, Thomas Jacques2, Daniel O. Iyayi2, Xiao Zhang5, Ronald H. Wender2
Affiliation
- 1Department of Anesthesiology, Charles R, Drew University of Medicine and Science, Los Angeles, CA, USA
- 2Department of Anesthesiology, Cedars-Sinai Medical Center, Los Angeles, CA
- 3Department of Anesthesiology, First Affiliated Hospital of China Medical University, Shenyang, China
- 4Department of Anesthesiology, Cedars Sinai Medical Center in Los Angeles, President, White Mountain Institute, The Sea Ranch, CA, USA
- 5Department of Biostatistics & Bioinformatics, Cedars-Sinai Medical Center, Los Angeles, CA
Corresponding Author
Paul F. White, PhD, MD, FANZCA, Department of Anesthesiology, Cedars Sinai Medical Center in Los Angeles, President, The White Mountain Institute, The Sea Ranch, CA, USA, Tel: +1 (214)-770-3775; FAX: +1 (310)-423-4119; E-mail: Paul.White@cshs.org; Whitemountaininstitute@hotmail.com
Citation
White, P.F., et al. Effect of Obesity on the Time Required Achieving a FEO2 of 90% during Preoxygenation. J Diabetes Obes (2015) 2(2): 102- 107.
Copy rights
© 2015 White, P.F. This is an Open access article distributed under the terms of Creative Commons Attribution 4.0 International License.
Keywords
Abstract
An end-expiratory oxygen (FEO2) concentration > 90% is desirable prior to tracheal intubation. We hypothesized that the time required for pre oxygenation to achieve an FEO2 of 90% was related to patient Body Mass Index (BMI). Seventy- seven consenting patients undergoing a rapid sequence induction were enrolled. After the anesthesia rebreathing circuit was filled with 100% oxygen for 4 min, these unpremeditated patients were instructed to breathe normally following application of a tight-fitting face mask with oxygen flowing at 10 L min-1. End-tidal oxygen and carbon dioxide values were recorded during the pre oxygenation period. Induction of anesthesia was performed when the FEO2 reached 90% or after 5 min of pre oxygenation in a standardized fashion. The times to achieve an FEO2 of 90% were 152 ± 57, 136 ± 62 and 136 ± 70 sec in the normal, overweight and obese subgroups, respectively. A total of 7 patients failed to achieve an FEO2 90% after 5 min of preoxygenation. Four patients also experienced a decrease in SpO2 < 95% during the apneic period prior to tracheal intubation (3 in the obese group and 1 in the overweight group). The mean BMI (± SD) of the patients who failed to achieve a FEO2 of 90% was 40 ± 9 kg/m². The time required to achieve an FEO2 of 90% during preoxygenation period was unrelated to the patient’s BMI. However, morbidly obese patients were more likely to experience a fall in their SpO2 to < 95% during the induction period.
