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Transnasal Humidified Rapid-Insufflation Ventilatory Exchange for Elective Laryngeal Surgery During Pregnancy: A Case Report.
A A Pract 2019P

Abstract

Transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) maintains oxygenation and blunts the partial pressure of carbon dioxide (PaCO2) rise in nonpregnant subjects during apnea. Physiologic changes of pregnancy may attenuate the utility of THRIVE. We present a nulliparous patient at 31 weeks' gestation undergoing tracheal dilation requiring general anesthesia without intubation utilizing THRIVE. Our data confirms prior reports in nonpregnant patients showing markedly extended time to desaturation. However, PaCO2 rise more closely mirrors classic apneic oxygenation in nonobstetric patients. The PaCO2 elevation and subsequent acidosis may limit the utility of THRIVE for prolonged apnea in pregnant surgical patients.

Authors+Show Affiliations

From the Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California.Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31592829

Citation

Kowalczyk, John J., et al. "Transnasal Humidified Rapid-Insufflation Ventilatory Exchange for Elective Laryngeal Surgery During Pregnancy: a Case Report." A&A Practice, 2019.
Kowalczyk JJ, Carvalho B, Collins J. Transnasal Humidified Rapid-Insufflation Ventilatory Exchange for Elective Laryngeal Surgery During Pregnancy: A Case Report. A A Pract. 2019.
Kowalczyk, J. J., Carvalho, B., & Collins, J. (2019). Transnasal Humidified Rapid-Insufflation Ventilatory Exchange for Elective Laryngeal Surgery During Pregnancy: A Case Report. A&A Practice, doi:10.1213/XAA.0000000000001098.
Kowalczyk JJ, Carvalho B, Collins J. Transnasal Humidified Rapid-Insufflation Ventilatory Exchange for Elective Laryngeal Surgery During Pregnancy: a Case Report. A A Pract. 2019 Oct 4; PubMed PMID: 31592829.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Transnasal Humidified Rapid-Insufflation Ventilatory Exchange for Elective Laryngeal Surgery During Pregnancy: A Case Report. AU - Kowalczyk,John J, AU - Carvalho,Brendan, AU - Collins,Jeremy, Y1 - 2019/10/04/ PY - 2019/10/9/entrez JF - A&A practice JO - A A Pract N2 - Transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) maintains oxygenation and blunts the partial pressure of carbon dioxide (PaCO2) rise in nonpregnant subjects during apnea. Physiologic changes of pregnancy may attenuate the utility of THRIVE. We present a nulliparous patient at 31 weeks' gestation undergoing tracheal dilation requiring general anesthesia without intubation utilizing THRIVE. Our data confirms prior reports in nonpregnant patients showing markedly extended time to desaturation. However, PaCO2 rise more closely mirrors classic apneic oxygenation in nonobstetric patients. The PaCO2 elevation and subsequent acidosis may limit the utility of THRIVE for prolonged apnea in pregnant surgical patients. SN - 2575-3126 UR - https://www.unboundmedicine.com/medline/citation/31592829/Transnasal_Humidified_Rapid-Insufflation_Ventilatory_Exchange_for_Elective_Laryngeal_Surgery_During_Pregnancy:_A_Case_Report L2 - http://dx.doi.org/10.1213/XAA.0000000000001098 DB - PRIME DP - Unbound Medicine ER -