Pre-oxygenation in pregnancy: the effect of fresh gas flow rates within a circle breathing system.

Abstract

We have investigated the effect of oxygen flow rate on pre-oxygenation in pregnant patients at term using a circle system. Twenty patients presenting for elective Caesarean section maintained tidal volume breathing through a standard circle system for 3 min. Subjects were pre-oxygenated using oxygen flow rates of 5 l.min(-1), 10 l.min(-1) and 15 l.min(-1) presented in random order. The mean (SD) fractional end-tidal oxygen at the end of 3 min was 0.86 (0.07) for 5 l.min(-1), 0.92 (0.05) for 10 l.min(-1)and 0.90 (0.09) for 15 l.min(-1) (p < 0.001). Entrainment of air occurred in 22% of pre-oxygenation sessions. Oxygen flow rates of 10 l.min(-1) or above provide optimal pre-oxygenation using a circle system in term parturients. In our study, entrainment of air occurred in a surprisingly high percentage of cases.