Pharyngeal oxygen delivery device sustains manikin lung oxygenation longer than high-flow nasal cannula

Abstract

Purpose

Hypoxemia during a failed airway scenario is life threatening. A dual-lumen pharyngeal oxygen delivery device (PODD) was developed to fit inside a traditional oropharyngeal airway for undisrupted supraglottic oxygenation and gas analysis during laryngoscopy and intubation. We hypothesized that the PODD would provide oxygen as effectively as high-flow nasal cannula (HFNC) while using lower oxygen flow rates.

Methods

We compared oxygen delivery of the PODD to HFNC in a preoxygenated, apneic manikin lung that approximated an adult functional residual capacity. Four arms were studied: HFNC at 20 and 60 liters per minute (LPM) oxygen, PODD at 10 LPM oxygen, and a control arm with no oxygen flow after initial preoxygenation. Five randomized 20-minute trials were performed for each arm (20 trials total). Descriptive statistics and analysis of variance were used with statistical significance of P < 0.05.

Results

Mean oxygen concentrations were statistically different and decreased from 97% as follows: 41 ± 0% for the control, 90 ± 1% for HFNC at 20 LPM, 88 ± 2% for HFNC at 60 LPM, and 97 ± 1% (no change) for the PODD at 10 LPM.

Conclusion

Oxygen delivery with the PODD maintained oxygen concentration longer than HFNC in this manikin model at lower flow rates than HFNC.

Keywords:

• Continuous oxygen delivery
• high-flow nasal cannula
• oropharyngeal airway
• pharyngeal oxygen delivery device
• supraglottic oxygenation

Disclosure statement

JBH has patent interests in the airway device described herein. All other authors report no financial disclosures or conflicts of interest. Funding sources include departmental support only. No other commercial or noncommercial affiliations, associations, or consultancies exist.