Levitan’s no desat with nasal cannula for Infants with pyloric stenosis requiring intubation.
Its a short correspondence article in Paediatric Anaesthesia March2013, from Dr Sabrina Devala Bhagwan of Elmhurst Hospital, NYC. She is an anesthesiologist and married to Mr EmCrit, Scott Weingart himself. I knew he was famous by association!
Her letter describes her practice of applying nasal cannula for intubation of infants with pyloric stenosis requiring surgery. She attempts to drain the stomach whilst patient is awake but invariably reports this is often insufficient to prevent regurgitation. The nasal cannula provide 6-8L/min oxygen flow once patient is asleep and allow time for a careful intubation without recourse to BVM hand ventilation. She reports this makes supervising anesthesia residents performing the intubations a whole lot easier and safer by allowing greater safe apnoea times.
NODESAT in kids works. Just do it.