Effects of preoxygenation with the three minutes tidal volume breathing technique in the elderly

Hyoseok Kang, Hye Jin Park, Seung Kwon Baek, Juyoun Choi, So Jin Park, Hyoseok Kang, Hye Jin Park, Seung Kwon Baek, Juyoun Choi, So Jin Park

Abstract

Background: Preoxygenation with tidal volume breathing for 3 min is commonly used technique. An end tidal expiratory oxygen concentration greater than 90% is considerd to be adequate for preoxygenation. The aim of this study was to check the effects of preoxygenation on elderly patients through the comparison with young patients during the 3 min tidal volume breathing technique.

Methods: Sixty patients from ASA class I or II who were scheduled for elective orthopedic general surgery were divided into an elderly (>65 yr) group and a control (25-65 yr) group. Patients were instructed in the technique of preoxygenation. Preoxygenation was accomplished with an appropriately sized face mask connected to an anesthesia machine with 100% oxygen during 3 min with patients in both groups. Expired O(2), CO(2) concentration and oxygen saturation were recorded simultaneously for 3 min.

Results: The elderly group showed significantly lower end tidal oxygen concentration than the control group from 50 sec to the end of study (180 sec) with the 3 min tidal volume breathing technique (P < 0.05). In 180 sec, the control group had over 90% (91.5%) end tidal oxygen concentration, but in the elderly group end tidal oxygen concentration could not reach 90% (86.2%). In oxygen saturation, the elderly group showed a significantly lower level until 40 sec from the start of study, and then two groups showed a similar levels of oxygen saturation until the end of study.

Conclusions: End tidal oxygen concentration did not reach 90% in 180 sec in the elderly group during preoxygenation with the 3 min tidal volume breathing technique.

Keywords: 3 min tidal volume breathing; Elderly; Mask; Oxygen concentration; Preoxygenation.

Figures

Fig. 1
Fig. 1
Comparison of control (25-65 yr) and elderly (>65 yr) group on end tidal oxygen concentration with the 3 min tidal volume breathing technique. Elderly group shows significantly lower end tidal oxygen concentration than control group from 50 sec to 180 sec. EtO2: end tidal oxygen concentration, *P < 0.05 compared to control group.
Fig. 2
Fig. 2
Comparison of control (25-65 yr) and elderly (>65 yr) group on oxygen saturation with the tidal volume breathing technique. Elderly group shows significantly lower oxygen saturation than control group until 40 sec. SpO2: oxygen saturation by pulse oximetry, *P < 0.001 compared to control group.
Fig. 3
Fig. 3
Comparison of control (25-65 yr) and elderly (>65 yr) group on end tidal CO2 concentration with the tidal volume breathing technique. There is no significant difference between the groups. EtCO2: end tidal carbon dioxide concentration.

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