You know that I obsess over the physiologically difficult airway–well there turns out to be an ED Crit Care doc who is equally as obsessive–Jarrod Mosier. Today, we talk about the hypoxemic physiologically difficult airway and many things preox!

Jarrod Mosier, MD FCCM

Associate Professor, Emergency Medicine
Associate Professor, Medicine
Associate Program Director, Critical Care Fellowship
Medical Director, Adult ECMO (Extracorporeal Membrane Oxygenation) Service
University of Arizona College of Medicine


We Discuss…

Preox Strategies

Pendelluft Phenomenon


Moody Teenager Lung


Rough Notes

#### Mosier JM Br J Anaesth 2020;125(1):e1
far right of the bell curve of risk of desaturation
- Need a reasonable FRC
- full oxygenation of that FRC
- That volume connected to the alveolar vessels -to be transmitted to the bloodstream
Tanoubi et al. estimation of safe apnea time formula

Why doesn't apox work
it is shunt fraction and its syngergistic partner low SvO2

Need a lot more PEEP when transitioning from NPV to PPV

PEEP is maint. in addition to recruitment

Pendelluft Phenomena movement of gas from recruited lung to non-recruited causing lung injury

he also postulates an abrupt increase in r sided heart pressures made even worse by bagging

Does 100% precipitate absorption atelectasis--no! put in the article from crashing patient

#### Mosier et al. WestJem  2015;16(7):1109
added R sided failure to the HOP killers
nebulized milrinone

#### Mosier et al. Intens Care Med 2017;43:226
in the lungs PaO2 creates the sat in the blood, the sat creates the PaO2


Dr. Mosier's Relevant Publications


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