Apneic Oxygenation during Rapid Sequence Intubation in Critically Ill Children

This prospective case series documented hypoxemia and potential complications associated with apneic oxygenation in critically ill pediatric patients during rapid sequence intubation. Forty-four patients received apneic oxygenation via nasal cannula at rates of 5, 10, and 15 L/min for ages <4, 4 to 12, and 12 to 18 years, respectively. Pre- and postintubation attempt mean Spo(2) were 98.9 +/- 2.95 and 90.7 +/- 1.95%, respectively. Postintubation Spo(2) < 80% were significantly less with one intubation attempt, compared with multiple attempts (p < 0.001). No serious complications were noted. Apneic oxygenation was well tolerated in critically ill children.