The investigators and other groups have demonstrated that high-flow nasal oxygen used during preoxygenation for emergency surgery is at least equally effective as preoxygenation compared to standard tight fitting mask. The investigators also have data from a recent study that indicates that high-flow nasal oxygen might decrease the risk of clinically relevant desaturation below 93% of arterial oxygen saturation. The studies investigating the concept of high-flow nasal oxygen has up to this date excluded pregnant women. Pregnant woman is a patient group with known difficulties to maintain adequate saturation levels during apnoea. Due to smaller functional residual capacity their oxygen stores after preoxygenation are smaller compared to patients with a normal body mass index. The pregnant woman also have a higher oxygen demand and metabolism due to the growing placenta and the fetus. Pregnant women are therefore a patient group where a method that could prolong time until desaturation would be even more valuable and potentially could save lives. Based on the above, the investigators now aim to conduct a clinical pilot study, where pregnant women undergoing caesarian section under general anesthesia are pre and perioxygenated with high-flow nasal oxygen. Data from that group will be compared with patients preoxygenated in a traditional manner with tight facemask. This study is done to evaluate an established technique on a patient category that in theory could gain a lot from it.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
34
Pregnant women scheduled for cesarian section in general anaesthesia will be preoxygenated using nasal high flow oxygen
Karlstads Centralsjukhus
Karlstad, Sweden
Danderyds Hospital
Stockholm, Sweden
Karolinska University Hospital, Solna
Stockholm, Sweden
Södersjukhuset
Stockholm, Sweden
Number of patients with peripheral arterial oxygen saturation below 93% from start of pre-oxygenation until one minute after tracheal intubation and comparison between intervention and control
arterial peripheral oxygen saturation
Time frame: Up to 1 minute after intubation
Comparison of Endtidal concentration of oxygen after intubation between intervention and control
Time frame: The first breaths after intubation eg. within 20 seconds of intubation
Comparison of Endtidal carbondioxide concentration after intubation between intervention and control
Time frame: The first breaths after intubation eg. within 20 seconds of intubation
Comparison of Number of patients with regurgitation of gastric contents between intervention and control
Time frame: During intubation eg up to 0 seconds after intubation
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