2012 OPEN FORUM Abstracts
A COMPARISON OF ORAL VS BITE BLOCK INSPIRED OXYGEN CONCENTRATION DURING FLEXIBLE BRONCHOSCOPY IN A SPONTANEOUS BREATHING LUNG MODEL.
Gagan Singh, David Vines; Rush University, Chicago, IL
BACKGROUND: Fiberoptic bronchoscopy (FOB) is an invasive procedure that allows clinicians to directly observe the tracheobronchial tree. One of the most common complications of FOB is hypoxia, which is corrected by supplemental oxygen. This study compared the inspired FIO2 when using the nasal cannula (NC) in the mouth and the bite block during FOB. Method: The Laerdal AirMan (Laedral, Wappingers Fall, New York) was attached to a Michigan Test Lung TTL (Michigan Instruments Inc.). This lung was driven by PB 7200 (Covidien, Boulder, CO) to simulate spontaneous breathing. The compliance of the test lung was set to 40 cm H2O/L with a fixed airway resistance of 5 cm/H20/L/sec. The Storz 14-33 Rigid Bronchoscope was advanced pasted the manikins carina into the right mainstem. FiO2, flow, and pressure measurements were made in-line between the right main stem and test lung. The volume delivered to the lung was exhaled through a one-way valve to prevent contamination with previously inspired gas. Pressure, flow and volume measurements were made using a NICO cardiopulmonary monitor (Philips Electronics, Andover, MA). FIO2 was analyzed using an oxygen analyzer (maxo2me, maxtec, Salt Lake City, UT). The driver was set on CMV, rate of 10, 18 and 25, sine flow waveform, VT of 400, 600, 800 mL, and peak flows of 40, 60, 80 and 120 LPM. Oxygen flow of 2, 4, 6, 8 and 10 L/m were provided to the manikin via the NC in the mouth and the bite block (Smart OmniBloc, Oridion, Needham, MA). RESULTS:: See table 1. a. Significantly greater than 2L/min by mouth or bite block (p < 0.05) b. significantly greater than 4L/min by mouth or bite block (p < 0.05) c. significantly greater than 6L/min by mouth (p < 0.05) CONCLUSIONS: There were no significant differences between the inspired oxygen concentration between the NC in the mouth and bite block at the same liter flow. Inspired oxygen increased significantly with increases in liter flow from 2 to 8 L/min with both methods of delivery. Both devices may provide similar inspired oxygen concentrations during FOB. Sponsored Research - None Sponsored Research - None Means (SD) of the measures on both methods of oxygen delivery.