Investigating the evolution and application of Optiflow in managing unique patient groups in the perioperative periodTools Valentine, Rebecca (2025) Investigating the evolution and application of Optiflow in managing unique patient groups in the perioperative period. PhD thesis, University of Nottingham.
AbstractThis thesis utilises computational modelling to explore the different applications of High Flow Nasal Oxygenation, specifically, Optiflow (Fisher & Paykel Healthcare, Auckland, New Zealand) device, an oxygen therapy device that delivers high-flow, humidified oxygen via nasal cannula. The thesis explores the strengths and weaknesses of Optiflow being used on a variety of patient groups including: the obese, the pregnant and the older population, and concludes that it is often beneficial and potentially superior to alternative oxygenation techniques such as traditional face mask ventilation. All of the following studies focus exclusively on supporting subjects during apnoea (i.e. cessation of breathing) in the perioperative period. All of the research presented in this thesis explore potential improvements that could be made to current pre-oxygenation techniques (i.e. administration of 100% of oxygen before the induction of anaesthesia via a tightly fitting face mask) and concludes that changes to pre-oxygenation times could offer better patient protection against injurious hypoxaemia. There is also discussion of whether Optiflow is the best technique to support patients when compared to tight fitting face masks and low flow nasal oxygenation and it is concluded that it is able to achieve equal to or better safe apnoea times and oxygenation. All investigations were conducted using the Interdisciplinary Collaboration in System Medicine (ICSM) simulation suite, developed by my supervisors and their collaborators and has already been widely validated to explore apnoea. As all data are computational in nature and so no true human data were collected, computational patients will be referred to throughout as subjects, so as not to cause ambiguity.
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