Endotracheal tube versus face mask with and without continuous positive airway pressure (CPAP). 1993

I Jousela
Department of Anaesthesia, Helsinki University Central Hospital, Finland.

Various ways of delivering continuous positive airway pressure (CPAP) have been extensively studied, with little attention, however, being paid to the effects of an intubation tube compared with breathing through a face mask, with or without CPAP. Pulmonary and cardiovascular variables were measured while 12 patients recovering from coronary artery bypass grafting were spontaneously breathing at ambient airway pressure, then at 7.4 mmHg (1 kPa) CPAP, and again at ambient pressure just before extubation. The same stages were repeated immediately after extubation, with patients breathing through a tight-fitting face mask. Arterial oxygen tension (Pao2, mean +/- s.d.) was better when the patients were breathing at ambient pressure through a face mask (11.7 +/- 2.8 kPa) than when they were intubated (10.6 +/- 2.4 kPa, P < 0.05). Compared with ambient pressure, CPAP (7.4 mmHg) (1 kPa) increased Pao2 in both modes (13.4 +/- 3.5 kPa with mask, and 12.6 +/- 3.5 kPa when intubated, n.s.). The best arterial oxygen saturation was measured during CPAP with a face mask (96 +/- 1%). Cardiac output remained unchanged in all the breathing modes. After coronary artery bypass grafting, spontaneous breathing with a face mask resulted in better Pao2 than breathing through an endotracheal tube, both with and without 7.4 mmHg (1 kPa) CPAP. This study indicates that unnecessary delay in extubation should be avoided.

UI MeSH Term Description Entries
D007442 Intubation, Intratracheal A procedure involving placement of a tube into the trachea through the mouth or nose in order to provide a patient with oxygen and anesthesia. Intubation, Endotracheal,Endotracheal Intubation,Endotracheal Intubations,Intratracheal Intubation,Intratracheal Intubations,Intubations, Endotracheal,Intubations, Intratracheal
D008168 Lung Either of the pair of organs occupying the cavity of the thorax that effect the aeration of the blood. Lungs
D008297 Male Males
D008397 Masks Devices that cover the nose and mouth to maintain aseptic conditions often for the prevention of the spread of infections (e.g. COVID19) or to administer inhaled anesthetics or other gases. Mask
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010100 Oxygen An element with atomic symbol O, atomic number 8, and atomic weight [15.99903; 15.99977]. It is the most abundant element on earth and essential for respiration. Dioxygen,Oxygen-16,Oxygen 16
D010101 Oxygen Consumption The rate at which oxygen is used by a tissue; microliters of oxygen STPD used per milligram of tissue per hour; the rate at which oxygen enters the blood from alveolar gas, equal in the steady state to the consumption of oxygen by tissue metabolism throughout the body. (Stedman, 25th ed, p346) Consumption, Oxygen,Consumptions, Oxygen,Oxygen Consumptions
D010994 Pleura The thin serous membrane enveloping the lungs (LUNG) and lining the THORACIC CAVITY. Pleura consist of two layers, the inner visceral pleura lying next to the pulmonary parenchyma and the outer parietal pleura. Between the two layers is the PLEURAL CAVITY which contains a thin film of liquid. Parietal Pleura,Visceral Pleura,Pleura, Parietal,Pleura, Visceral
D011175 Positive-Pressure Respiration A method of mechanical ventilation in which pressure is maintained to increase the volume of gas remaining in the lungs at the end of expiration, thus reducing the shunting of blood through the lungs and improving gas exchange. Positive End-Expiratory Pressure,Positive-Pressure Ventilation,End-Expiratory Pressure, Positive,End-Expiratory Pressures, Positive,Positive End Expiratory Pressure,Positive End-Expiratory Pressures,Positive Pressure Respiration,Positive Pressure Ventilation,Positive-Pressure Respirations,Positive-Pressure Ventilations,Pressure, Positive End-Expiratory,Pressures, Positive End-Expiratory,Respiration, Positive-Pressure,Respirations, Positive-Pressure,Ventilation, Positive-Pressure,Ventilations, Positive-Pressure
D011312 Pressure A type of stress exerted uniformly in all directions. Its measure is the force exerted per unit area. (McGraw-Hill Dictionary of Scientific and Technical Terms, 6th ed) Pressures

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