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Apneic Oxygenation With High-Flow Nasal Cannula and Transcutaneous Carbon Dioxide Monitoring During Airway Surgery

A Case Series

Ebeling, Callie Gittemeier, MD; Riccio, Christina Anne, MD

doi: 10.1213/XAA.0000000000000931
Case Reports

Three patients underwent laryngeal and tracheal surgeries under apneic conditions using transnasal humidified rapid-insufflation ventilatory exchange. Transcutaneous carbon dioxide (CO2) levels were recorded throughout the apneic period to detect rates of CO2 rise. Conventional airway management was initiated after 15 minutes of apnea with either tracheal intubation or jet ventilation. No patient experienced oxygen desaturation <97%. The average rate of transcutaneous CO2 rise (1.7 mm Hg/min) was higher than previously reported using this technique. This suggests a need for further investigation into the utility of transnasal humidified rapid-insufflation ventilatory exchange for airway surgery and adequate ventilation during apnea.

From the Department of Anesthesiology & Pain Management, UT Southwestern Medical Center, Dallas, Texas.

Accepted for publication October 16, 2018.

Funding: None.

Conflicts of Interest: See Disclosures at the end of the article.

Address correspondence to Callie Gittemeier Ebeling, MD, 5323 Harry Hines Blvd, Dallas, TX 75390. Address e-mail to

© 2019 International Anesthesia Research Society
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