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OptiflowTM via AirvoTM High/Low Flow Oxygen Delivery System

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Presentation on theme: "OptiflowTM via AirvoTM High/Low Flow Oxygen Delivery System"— Presentation transcript:

1 OptiflowTM via AirvoTM High/Low Flow Oxygen Delivery System
Devika Cook Charge Nurse Adult and Emergency PACU Auckland City Hospital

2 What is the definition of a double blind study?

3 Two Orthopaedic Surgeons trying to read an ECG!

4 Objectives

5 OptiflowTM Nasal High/Low Flow Oxygen Therapy
Designed to meet inspiratory demand Provides natural balance of temperature and humidity Low level positive airway pressure Used in conjunction with the AirvoTM

6 AIRVOTM High-performance humidifier and integrated flow generator
Consistent temperature & humidity level Accurate FiO2 with a constant flow rate Ability to alter flow rate (15-45 lpm and oxygen percentage 21-60%)

7 Indications for Use Increased respiratory demand
Intolerance of conventional face mask Hypoxia/Emergence Agitation Major surgery – abdominal, head and neck High BMI Obesity Smoker

8 Benefits Easy to implement Comfort → patient compliance
Not affected by NGT Can prevent less invasive ventilation Direct Delivery to Naso/Oro-Pharynx Less dilution effect

9 Benefits - cont Disadvantage
Warm humidified oxygen Less damage to mucosa Improved gas exchange and O2 saturation Decreased LOS in PACU Transferable system for ward use Reduced care costs Disadvantage No battery pack, dependent on AC power

10 Case Study 34 year old male caucasian Post-Op Lap Appendicectomy
ASA 1 – training for Auckland Marathon ? Aspirated on induction CXR – “slight” Pulmonary Oedema Decreased saturations in PACU

11 Clinical Presentation
Patient not distressed Breathing not laboured Hudson Mask on 15 litres Persistent low sats 88-90% Nil complaints of Pain or PONV Circulation stable Medical request for CPAP circuit

12 CPAP Circuit “Dolly Parton”

13 OptiflowTM/AirvoTM Circuit

14 Treatment 1400 - OptiflowTM via AirvoTM commenced
Initially set for high oxygenation 15 lpm of oxygen (piped via flow meter) 15 lpm flow rate (generated by AirvoTM) Approximate oxygen concentration 63% Arterial line inserted ABG’s at 30 minute intervals

15 Treatment - cont 1500 – sats slight improvement to 92%
1600 – sats up to 94% 1630 – commenced weaning of O2 ↓Oxygen flow 7 lpm(50%) ↑Flow rate to 30 lpm Saturations constant in mid 90’s Constant monitoring of ABG’s & pulse ox OptiflowTM/AirvoTM titrated for effect

16 AIRVOTM Table

17 Outcome Referred to HDU → “wait & see”
Oxygen flow decreased incrementally Steady improvement in saturations Re-routing of ward Six hours later stable Oxygen flow ↓ 5 lpm Flow rate maintained at 35 lpm approx 32% Maintaining saturations at 97-98% 2000-transferred to Gen Surg ward with OptiflowTM/AirvoTM

18 Resolution 24 hours later CXR Pulmonary Oedema resolved completely
Maintaining adequate saturations on air 48 hours – discharged home Unable to complete the Marathon 

19 “Simply Better Oxygen Therapy”
Conclusion Early intervention with OptiflowTM/AirvoTM O2 delivery and humidification does have an impact on patient outcomes Works relatively quickly – sustained effect Suitable for patients when conventional masks are not feasible Can decrease LOS in PACU “Simply Better Oxygen Therapy”

20 Acknowledgements Product Specialist F & P Annelise La Roche
Materials Management ACH Nurse Educators PACU Liz Boucher & Penny Jones Level 8 PACU RN’s For embracing the technique and ongoing support of the system

21 The A, B, C of Anaesthesia Airway Bagel Coffee

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