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GENERAL ARTICLES

Oxygenation Using Tidal Volume Breathing After Maximal Exhalation

Department of Anesthesiology, American University Medical Center, Beirut, Lebanon

Address correspondence and reprint requests to Anis Baraka, MD, FRCA, American University of Beirut, Department of Anesthesiology, PO Box 11 0236, Beirut, Lebanon. Address e-mail to abaraka{at}aub.edu.lb

We compared, in volunteers, the oxygenation achieved by tidal volume breathing (TVB) over a 3-min period after maximal exhalation with that achieved by TVB alone. Twenty-three healthy volunteers underwent the two breathing techniques in a randomized order. A circle absorber system with an oxygen flow of 10 L/min was used. The end-expiratory oxygen concentration (EEO₂) was monitored at 15-s intervals up to 3 min. TVB after maximal exhalation produced EEO₂ values of 68% ± 5%, 75% ± 5%, and 79% ± 4% at 30, 45, and 60 s, respectively, which were significantly larger (P < 0.05) than the corresponding values obtained with TVB alone (58% ± 5%, 66% ± 6%, and 71% ± 5%, respectively). In both techniques, the EEO₂ increased exponentially, with time constants of 35 s during TVB after maximal exhalation versus 58 s during TVB without prior maximal exhalation. In conclusion, maximal exhalation before TVB can hasten preoxygenation by decreasing the nitrogen content of the functional residual capacity, with a consequent increase of EEO₂ to approximately 70% in 30 s and 80% in 60 s.

IMPLICATIONS: Oxygenation by using maximal exhalation before tidal volume breathing produced a significantly faster increase in end-expiratory oxygen concentration than oxygenation with tidal volume breathing alone.

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Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999