• Rhys S Holyoak, Thomas M Melhuish, Ruan Vlok, M Binks, and Leigh D White.
• School of Medicine, University of Wollongong, NSW, Australia.
• J Crit Care. 2017 Oct 1; 41: 42-48.

PurposeTo determine whether or not apnoeic oxygenation reduces the incidence of hypoxaemia during endotracheal intubation.Materials And MethodsA systematic search of six databases for all relevant studies until November 2016 was performed. All study designs using apnoeic oxygenation during intubation were eligible for inclusion. All studies were assessed for level of evidence and risk of bias. A meta-analysis was performed on all data using Revman 5.3.ResultsSeventeen studies including 2422 patients were retrieved. Overall there was a significant reduction in the incidence of desaturation (RR=0.65; p<0.00001), critical desaturation (RR=0.61, p=0.002) and safe apnoea time (WMD=1.73min, p<0.00001). There was no significant difference in mortality (RR=0.77, p=0.08).ConclusionsIn patients whom are being intubated for any indication other than respiratory failure, apnoeic oxygenation at any flow rate 15L or greater is likely to reduce their incidence of desaturation (<90%) and critical desaturation (<80%). However, further high quality RCTs are required given the high degree of heterogeneity in many of the outcomes and subgroup analyses.Copyright © 2017 Elsevier Inc. All rights reserved.

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