Poster 010: Apneic Oxygenation for Fifteen Minutes Achieved Using a Commercial Device in a Paralyzed Porcine Model

Background: A new endotracheal-tube–compatible device was tested for apneic oxygenation during difficult intubations. Extending prior 10-minute success in paralyzed pigs, this study evaluated 15-minute performance, assessing oxygenation and ventilation via arterial blood gases (PaO₂, PaCO₂, pH), demonstrating its potential to maintain oxygenation during prolonged apnea

Methods: Twelve complete apneic intubation cycles, alternating between control (endotracheal tube without oxygen) and test cycles using Turbo® O₂ Cap (a Class I commercially available device) delivering 15 L/min of 100 % oxygen, were performed using three adult Yorkshire pigs (4 cycles each). The primary endpoint was oxygen saturation (SpO₂). Fisher’s exact test compared saturation outcomes between control and test runs. Arterial blood gases (PaO₂, PaCO₂, pH) were obtained during one of the two test runs for each pig (three of six test runs total) at prespecified time points; no ABGs were obtained during control runs.

Outcome: All test cycles using the new device maintained SpO₂ ≥ 94 % for the full 15 minutes, whereas in all control cycles SpO₂ dropped below 75 % within one minute of paralysis (Fisher’s exact p = 0.0022), confirming a minimum of 15 minutes of hypoxia prevention with the novel device. Test cycle ABGs showed PaO₂ was high at baseline and actually increased over time; PaCO₂ increased modestly, but animals remained survivable without intervention; pH decreased slightly, remaining just below 7.2; statistical analysis was not done due to sample size.

Conclusion: In large animal studies, the novel device for apneic oxygenation via the endotracheal tube performed well in an animal model and reliably eliminates hypoxemia for 15 minutes during simulated difficult intubation under paralysis, representing a potentially transformative advance toward solving the problem of hypoxia during apneic intubation.