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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com




Saturday, October 31, 2015

FELLOW trial

The Fellow Trial
R.E.B.E.L. EM - October 12, 2015 - By Salim Rezaie
Post Peer Reviewed By: Swaminathan A and Astin M
"Background: Every year there are a handful of “game changing” publications that truly change how we care for our patients. One such paper was a paper by Scott Weingart and Richard Levitan in the Annals of Emergency Medicine in 2011 on the topics of preoxygenation and apneic oxygenation (This paper was already reviewed on REBEL EM –Preoxygenation and Apneic Oxygenation). As many of us know, one of the most common and feared complications dealt with in critically ill patients requiring endotracheal intubation is hypoxemia. Hypoxemia can subsequently lead to cardiac arrest and death. Since the advent of apneic oxygenation this common complication seems to have decreased in occurrence, but is apneic oxygenation effective in all settings?
Author Conclusion: Apneic Oxygenation does not appear to increase lowest arterial oxygen saturation during endotracheal intubation of critically ill patients compared to usual care. These findings do not support routine use of apneic oxygenation during endotracheal intubation of critically ill adults
Clinical Take Home Point: In critically ill patients requiring intubation, if you use BPAP or BVM during the pre-oxygenation period, you may not get as much benefit from apneic oxygenation. However, it is important to remember that apneic oxygenation is cheap, low risk (no risk) intervention, with no proven harms to date."