A Nasal Cannula Under the Noninvasive Positive Pressure Ventilation Mask?

A crossover trial in healthy volunteers suggests that a nasal cannula does not increase mask leaking significantly.

Research suggests that apneic oxygenation is of benefit during rapid sequence intubation (NEJM JW Emerg Med Sep 2017 and Am J Emerg Med 2017; 35:1184). Apneic oxygenation involves use of high-flow oxygen via a nasal cannula during laryngoscopy. In practice, it means that patients who may require intubation are given a nasal cannula and a non-rebreather mask or noninvasive positive pressure ventilation (NPPV).

To evaluate whether a nasal cannula causes the NPPV mask to leak, investigators enrolled 64 healthy volunteers in a crossover study in which each participant served as his or her own control. Participants underwent 1 minute of NPPV with a nasal cannula and 1 minute of NPPV without a nasal cannula, in random order, with a 2-minute washou…

Reviewing Author

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education

Grant/Research SupportAgency for Healthcare Research and Quality; CDC; NIH–National Center for Advancing Translational Sciences; NIH–National Institute of Allergy and Infectious Diseases (NIAID); NIH–NIAID–Antibacterial Resistance Leadership Group; Merck; Pfizer; Boehringer-Ingelheim; Shire; Portola Pharmaceuticals, Inc.; Novartis; bioMérieux; Siemens; Rapid Pathogen Screening; Magnolia; Stago; Innovative Biosensors; Molecular Detection, Inc.; Dyax Corp.; Trius Pharmaceuticals

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education

A Nasal Cannula Under the Noninvasive Positive Pressure Ventilation Mask?

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Reviewing Author