Oxygen flow through nasal cannulae

Abstract

Purpose: Since many operating theatres do not have distinct oxygen flowmeters, flow rates of oxygen were measured via nasal prongs at several settings and attachments to three anaesthetic machines. Methods: Oxygen flow rates were measured using a Timeter R T-200 Calibration Analyzer at three, five and eight L · min-1 via nasal prongs attached to a distinct flowmeter, the common gas outlet (CGO) and the Y-piece of a circle system with the adjustable pressure release (APL) valve closed, open and partially open at circuit pressures of 10 and 20 cm H2O. Results: The most accurate delivery of oxygen was from a distinct flowmeter and the CGO (mean difference 0.2 ± 0.2 and 0.4 ± 0.4 respectively). Differences between the flowmeter and CGO were not significant (P = 0.1). Accuracy of flows via the Y-piece were worse than via the flowmeter and CGO (P < 0.0001). Flows via the Y-piece were less than those dialed, especially at high rates. With a partially open APL valve, flow depended upon pressure in the anaesthetic circuit, not upon the flow set. With the APL valve completely open, no flow occurred. Conclusions: To deliver supplemental oxygen in the operating theatre when there are no distinct flowmeters, nasal prongs should be attached to the CGO of the anaesthetic machine or a flowmeter on a portable E-tank oxygen cylinder. Connecting nasal prongs to the Y-piece of a circle system should be avoided since oxygen delivery is less than dialed, especially when the APL valve is open.