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Contribution of the nasal passage to face mask ventilation: a prospective blinded randomized crossover trial

AbstractBackgroundPrevious studies have shown that the nasal passage plays an important role in manual face mask ventilation, but this has yet to be quantitatively assessed. We conducted a prospective randomized crossover clinical trial to compare the change in pressure-controlled face mask tidal volume with and without nasal airway occlusion.MethodFemale patients undergoing elective surgery under general anesthesia served as study subjects. Patients were randomly assigned to face mask ventilation beginning either with or without nasal passage occlusion (achieved with a swimmer ’s nose clip), followed by removal or application of the nose clip, respectively. After standardized induction of general anesthesia and muscle paralysis, a tight-fitting face mask was applied to each patient, and tidal volume was measured by the anesthesia machine during pressure-controlled venti lation (10, 15, 20 cm H2O; 8 breaths ·min−1; inspiratory:expiratory ratio 1:2).ResultsThe median [interquartile range] tidal volume was lower withvs without nasal passage occlusion at 10 cm H2O inspiratory pressure (100 [55-134] mLvs 300 [230-328] mL, respectively; median difference (MD), 200 mL; 95% confidence interval (CI), 157 to 229;P
Source: Canadian Journal of Anesthesia - Category: Anesthesiology Source Type: research

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