Apneic Oxygenation: A Narrative Review

• Published in: Current anesthesiology reports (Philadelphia) Vol. 14; no. 3; pp. 426 - 437
• Main Authors: López, Teresa, Sastre, José A., Gómez-Ríos, Manuel Á.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.09.2024
• Subjects: Airway Management (L Berkow; Anesthesiology; Critical Care Medicine; Intensive; Internal Medicine; Medicine; Medicine & Public Health; Section Editor; Topical Collection on Airway Management; Apneic oxygenation; High-flow nasal oxygenation; Physiological difficult airway; Safe apnea time; Difficult airway
• ISSN: 2167-6275; 2167-6275
• DOI: 10.1007/s40140-024-00640-1

Purpose of Review The purpose of this review is to explore the underlying physiology and clinical applications of apneic oxygenation, a technique first described in humans in the mid-20th century. Specifically, we aim to summarize its significance in critical care and anesthetic management. Recent Findings High-flow nasal oxygenation (HFNO) has emerged as an innovative apneic oxygenation system with widespread acceptance, leading to its rapid adoption. Recent literature underscores the diverse applications of HFNO in perioperative medicine and its associated benefits. In this section, we analyze the latest available data and delineate the potential role of HFNO based on the current state of knowledge. Summary HFNO represents a groundbreaking advancement in apneic oxygenation, enhancing its efficacy significantly. This technique is rapidly gaining popularity due to its simplicity in setup, patient tolerability, and its capacity to deliver a high fraction of inspired oxygen along with positive airway pressure. Its versatility extends across various clinical scenarios, including induction of anesthesia and tubeless upper airway surgery. Furthermore, its utility extends to critical care, obese, obstetric, and pediatric patient populations.