Imperial College London
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Mr Ahmed R. Ahmed PhD FRCS

Faculty of Medicine, Department of Surgery & Cancer

Clinical Reader in Metabolic Surgery
 
 
 
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Contact

 

+44 (0)20 8846 1081a.ahmed07

 
 
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Location

 

Charing Cross HospitalCharing Cross Campus

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Summary

 

Publications

Citation

BibTex format

@article{Schutzer-Weissmann:2023:10.1016/j.bja.2021.12.011,
author = {Schutzer-Weissmann, J and Wojcikiewicz, T and Karmali, A and Lukosiute, A and Sun, R and Ahmed, A and Purkayastha, S and Brett, S and Cousins, J},
doi = {10.1016/j.bja.2021.12.011},
journal = {British Journal of Anaesthesia},
pages = {103--110},
title = {Apnoeic oxygenation in morbid obesity: a randomised controlled trial comparing facemask and high-flow nasal oxygen delivery},
url = {http://dx.doi.org/10.1016/j.bja.2021.12.011},
volume = {130},
year = {2023}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BackgroundObesity is a risk factor for airway-related incidents during anaesthesia. High flow nasal oxygen has been advocated to improve safety in high-risk groups but its effectiveness in the obese population is uncertain. This study compared the effect of high flow nasal oxygen and low flow facemask oxygen delivery on duration of apnoea in morbidly-obese patients.MethodsPatients undergoing bariatric surgery were randomly allocated to receive either high flow nasal (70 L min-1) or facemask (15 L min-1) oxygen. Following induction of anaesthesia, morbidly-obese patients were apnoeic for 18 minutes or until oxygen saturation dropped to 92%.ResultsEighty patients were studied (41 high flow nasal oxygen, 39 facemask). Median apnoea duration was 18 minutes in both the high flow nasal oxygen (IQR 18-18 minutes) and the facemask (IQR 4.1-18 minutes) groups. Five patients in the high flow nasal oxygen group and 14 patients in the facemask group desaturated to 92% within 18 minutes. The risk of desaturation was lower in the high flow nasal oxygen group (Hazard Ratio 0.27, 95% CI 0.11-0.65, p=0.007). ConclusionsIn experienced hands, apnoeic oxygenation is possible in the morbidly-obese and was tolerated for 18 minutes by the majority of patients, whether oxygen delivery was high flow nasal or low flow facemask. High flow nasal oxygen reduced desaturation risk compared to facemask oxygen. Desaturation risk is a more clinically relevant outcome than duration of apnoea. Individual physiological factors are likely to be the primary determinant of risk rather than method of oxygen delivery.
AU  - Schutzer-Weissmann,J
AU  - Wojcikiewicz,T
AU  - Karmali,A
AU  - Lukosiute,A
AU  - Sun,R
AU  - Ahmed,A
AU  - Purkayastha,S
AU  - Brett,S
AU  - Cousins,J
DO  - 10.1016/j.bja.2021.12.011
EP  - 110
PY  - 2023///
SN  - 0007-0912
SP  - 103
TI  - Apnoeic oxygenation in morbid obesity: a randomised controlled trial comparing facemask and high-flow nasal oxygen delivery
T2  - British Journal of Anaesthesia
UR  - http://dx.doi.org/10.1016/j.bja.2021.12.011
UR  - https://www.sciencedirect.com/science/article/pii/S000709122100800X?via%3Dihub
UR  - http://hdl.handle.net/10044/1/93249
VL  - 130
ER  -
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