A Novel Oxygenation Device, the Turbo® O2 Cap, Prevents Hypoxia for 15 min of Apnoea in a Porcine Model, Despite Paralysis: A Potential Paradigm Shift in Human Airway Management

Background and Aims: Apnoeic oxygenation has shown potential benefit during difficult intubations. Current methods to effectively deliver apnoeic oxygenation are limited. A novel, endotracheal-tube compatible device was developed to extend oxygenation during difficult or apnoeic intubations. Building on prior work demonstrating 10-min hypoxia prevention in fully chemically paralysed animals, this pre-clinical study evaluated performance over a 15-min window in the same porcine model while analysing arterial blood gas (ABG) parameters, including PaO 2 , PaCO 2 and pH. Methods: Twelve complete apnoeic intubation cycles, alternating between control (endotracheal tube [ETT] without oxygen) and test cycles using Turbo ® O 2 Cap (a Class I commercially available device) delivering 15 L/min of 100% oxygen, were performed using three adult Yorkshire pigs (four cycles each). The primary endpoint was oxygen saturation (SpO 2 ). Fisher’s exact test compared saturation outcomes between control and test runs. ABGs (PaO 2 , PaCO 2 and pH) were obtained during one of the two test runs for each pig (three of six test runs total) at pre-specified time points; no ABGs were obtained during control runs. Results: All test cycles using the new device maintained SpO 2 ≥ 94% for the full 15 min, whereas in all control cycles SpO 2 dropped <75% within 1 min of paralysis (Fisher’s exact P = 0.0022), confirming a minimum of 15 min of hypoxia prevention with the novel device. Test cycle ABGs showed PaO 2 was high at baseline and increased over time; PaCO 2 increased and pH decreased to approximately 7.2 during apnoea; these arterial blood–gas changes were reported as secondary, descriptive observations, and statistical analysis was not performed due to sample size. Conclusion: In large animal studies, the novel device for apnoeic oxygenation via the ETT performed well in an animal model and reliably eliminates hypoxaemia for 15 min during simulated difficult intubation under paralysis, representing a potentially transformative advance towards solving the problem of hypoxia during apnoeic intubation.