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Transnasal Humidified Rapid-Insufflation Ventilatory Exchange for Preoxygenation Before Cesarean Delivery Under General Anesthesia: A Case Report

Hengen, Maryse MD*; Willemain, Rosalie MD*; Meyer, Alain MD*; Langer, Bruno PhD; Joshi, Girish P. MBBS, MD, FFARCSI; Diemunsch, Pierre MD, PhD*

doi: 10.1213/XAA.0000000000000571
Case Reports: Case Report

Transnasal humidified rapid-insufflation ventilatory exchange has been shown to improve oxygenation and increase apnea time in difficult airway cases. It may also be beneficial in patients vulnerable to rapid desaturation due to limited pulmonary reserve. We report the use of transnasal humidified rapid-insufflation ventilatory exchange for preoxygenation before a cesarean delivery under general anesthesia in a patient with respiratory distress because of pneumonia and heart failure from severe mitral stenosis. To our knowledge, the use of this technique has not been previously reported in pregnant patients.

From the *Service d’Anesthésie-Réanimation Chirurgicale and Service de Gynécologie-Obstétrique, Hôpitaux Universitaires, Strasbourg, France; and Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas, Texas.

Accepted for publication April 14, 2017.

Funding: B. Langer has received payments from Procter and Gamble.

The authors declare no conflicts of interest.

Address correspondence to Maryse Hengen, MD, Department of Anesthesiology and Intensive Care, Centre Hospitalier Universitaire de Hautepierre, 1 avenue Molière, 67200 Strasbourg, France. Address e-mail to

© 2017 International Anesthesia Research Society
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