• Codruta N Soneru, Hans F Hurt, Timothy R Petersen, Donnis D Davis, Darren A Braude, and Ricardo J Falcon.
• Department of Anesthesiology & Critical Care Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico.
• Paediatr Anaesth. 2019 Jun 1; 29 (6): 628-634.

BackgroundApneic nasal oxygenation (ApOx) prolongs the time to desaturation during intubation of adult patients, but there is limited prospective evidence for apneic oxygenation in pediatric patients.AimsWe hypothesized that ApOx during operating room intubation of pediatric patients by inexperienced learners would prolong the interval before desaturation.MethodsThis prospective observational study compared intubation data for 196 pediatric surgical patients intubated by learners under baseline practice (no nasal cannula), to 160 patients enrolled after adoption of routine apneic nasal cannula oxygenation at 5 L/min. The primary outcome was elapsed time between anesthetic induction and pulse oximetry (SpO2 ) falling to 95, if ever.ResultsNasal cannula oxygenation during intubation by learners delayed desaturation to SpO2 95 (risk ratio for this event before intubation 0.05, 95% CI 0.03-0.09; P < 0.0001).ConclusionsApneic oxygenation via nasal cannula during intubation of pediatric surgical patients prolongs time before desaturation, thus extending the safe interval for airway management by learners.© 2019 John Wiley & Sons Ltd.

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