EA20 Newsletter: Avoiding Hypoxemia during Anaesthesia

During surgery, there is a potential risk of being exposed to a prolonged apnoea followed by an arterial haemoglobin desaturation. Obese, neonatal, paediatric, pregnant, septic, and critically ill patients are at a higher risk of showing a reduced oxygen reserve.

When apnoea occurs, the oxygen extraction from the alveoli to the arterial blood flow develops into a decrease of interalveolar pressure that becomes subatmospheric. This situation generates a pressure gradient that allows more oxygen to passively move into the alveolar space[1,2].

Apnoeic oxygenation is achieved by administering High flow nasal cannula (HFNC) oxygen and removing the nitrogen that otherwise would be accumulated in the lung and, combined with the carbon dioxide accumulation, diminishes the available pressure gradient for oxygen transfer to the alveolus and hastens the onset of hypoxaemia[3]. Apnoeic oxygenation may prolong safe apnoea time and increase first-pass success during emergency intubation[4].

Striving for best practise towards patient safety in anaesthesia settings, Mindray incorporates High Flow Nasal Cannula (HFNC) oxygen to the new A8/A9 anaesthesia systems, which contributes to safer patient management by addressing potential complications related to hypoxaemia during anaesthetic procedure and difficult airway management.

So, what else are the HFNC oxygen applications to increase patient safety in anaesthesia?


Explore Mindray’s dedicated perioperative journey for Euroanaesthesia2020 to read the full article: https://www.mindray.com/en/static/euroanaesthesia2020.html

Or watch the A9 Anesthesia System Global Launch Event: https://youtu.be/XHnWbpG6GKc




  1. Apfelbaum, J.L., et al., Practice guidelines for management of the difficult airway: an updated

report by the American Society of Anesthesiologists Task Force on Management of the Difficult

Airway. Anesthesiology, 2013. 118(2): p. 251-70.

  1. Frerk, C., et al., Difficult Airway Society 2015 guidelines for management of unanticipated

difficult intubation in adults. Br J Anaesth, 2015. 115(6): p. 827-48.

  1. Humphreys, S., et al., Transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) in

children: a randomized controlled trial. Br J Anaesth, 2017. 118(2): p. 232-238.

  1. Mushambi, M.C. and S.M. Kinsella, Obstetric Anaesthetists’ Association/Difficult Airway Society

difficult and failed tracheal intubation guidelines– the way forward for the obstetric airway. Br J

Anaesth, 2015. 115(6): p. 815-8.


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