• Nandhini Joseph, Sunil Rajan, Pulak Tosh, Dilesh Kadapamannil, and Lakshmi Kumar.
• Department of Anaesthesiology and Critical Care, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India.
• Anesth Essays Res. 2018 Jan 1; 12 (1): 246-250.

BackgroundPreoxygenation and apneic ventilation prolong apnea time without desaturation.AimsThe primary objective of this study is to compare arterial oxygenation during the periods of apnea following preoxygenation and apneic ventilation with tidal volume breathing for 3 min with continuous positive airway pressure (CPAP) versus with transnasal humidified rapid-insufflation ventilatory exchange (THRIVE).Settings And DesignsThis prospective randomized study was conducted in 20 adult patients at a tertiary care institution.Subjects And MethodsGroup C patients (n = 10) were preoxygenated with 100% oxygen using a face mask at a rate of 6 L/min for 3 min with CPAP of 15 cm of H2O. In Group H, oxygen was administered using THRIVE at 30 L/min for 3 min. Apneic ventilation was given in Group C with 10 L/min oxygen with CPAP of 15 cm H2O and in Group H with THRIVE at 60 L/min. The endpoint was desaturation to 90% or maximum duration of 12 min.Statistical Analysis UsedChi-square test and Mann-Whitney test.ResultsBoth groups tolerated apnea for 12 min without desaturation. PaO2 in Group C was significantly higher than Group H from 3 min of apnea to 12 min. The PaCO2 was significantly lower in Group C from 6 min. The pH was comparable in both groups except at 12 min with Group H having significantly lower pH.ConclusionTidal volume breathing with CPAP resulted in significantly higher arterial oxygen levels than THRIVE, though both modalities were equally effective in prolonging apnea time without desaturation up to 12 min. Group C showed an added advantage of lower PaCO2 with less acidemia.

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