Effectiveness of preoxygenation strategies: a systematic review and network meta-analysis
Authors' conclusion
Preoxygenation of adults before induction of general anaesthesia was most effective in terms of safe apnoea time when performed with high-flow nasal oxygen with patients in the head-up position in comparison with facemask alone.
Study context
- Population
- Adults (≥16 yr) receiving GA in any setting
- Participants
- 3,914 adults · 52 studies
- Comparison
- Preoxygenation techniques: HFNO head-up vs facemask supine or head-up
- Outcome
- Safe apnoea time
Methodological detailsGrading of Recommendations, Assessment, Development and Evaluation (GRADE) quality assessment
- GRADE quality assessment
Pooled result
As reported in the abstract
Mean difference, s (95% CrI)
HFNO head-up vs Facemask supine
291(138–456)
HFNO head-up vs Facemask head-up
203(79–343)
Further pooled results
| Outcome | Mean difference (s) (95% CrI) | |
|---|---|---|
| Safe apnoea time, studies without apnoeic oxygenation (subgroup)HFNO head-up vs Facemask supine · credible interval · CrI | 222 (63–378) | |
| Safe apnoea time, studies without apnoeic oxygenation (subgroup)HFNO head-up vs Facemask head-up · credible interval · CrI | 139 (15–262) | |
| −2000200400Difference, s (linear scale) |
Safe apnoea time, studies without apnoeic oxygenation (subgroup)
- HFNO head-up highest ranked technique
Oxygenation measure at end of preoxygenation (formula not shown in abstract)
- HFNO highest ranked technique for increase
Incidence of arterial desaturation
- Less likely with facemask with pressure support vs other techniques
Measure most likely lowest (formula not shown in abstract)
- Most likely lowest with deep breathing in supine position
Original publication
Effectiveness of preoxygenation strategies: a systematic review and network meta-analysis. Br J Anaesth. Published 9 April 2024. doi:10.
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