Transnasal Humidified Rapid-Insufflation Ventilatory Exchange in pediatric bronchoscopy: A prospective pilot study

Caruso, Thomas J.; O’Connell, Chloe; Qian, Jimmy; Menéndez, María; Fonseca, Ahtziri; Lawrence, Kiley A.; Sidell, Douglas; Darling, Curtis; Tsui, Ban C. H.

doi:10.1016/j.jclinane.2020.110086

Cited by 3 publications

(1 citation statement)

References 3 publications

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“…6,8,26 THRIVE has gained popularity since its introduction, 11 but current data on the usefulness of THRIVE for tubeless patient airways are included primarily in case series, retrospective reviews, or observational studies with few patients. 20,21,27–29 This study is clinically relevant: our results highlight the benefit of sustained oxygenation with THRIVE in allowing uninterrupted surgery, thereby reducing the overall procedure time, lessening the intraoperative repeated intubation frequency, and subsequently decreasing the lower airway spread risk since many children with JORRP must undergo multiple procedures throughout their childhood. 2–4 The prolonged apnea time without desaturation reduced the stress on both the trainee and supervisor, thus permitting an unrushed operation.…”

Section: Discussionmentioning

confidence: 69%

Transnasal Humidified Rapid Insufflation Ventilatory Exchange Augments Oxygenation in Children With Juvenile Onset Recurrent Respiratory Papillomatosis During Surgery: A Prospective Randomized Crossover Controlled Trial

Lei

et al. 2023

Anesthesia &Amp; Analgesia

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BACKGROUND: Evidence is lacking regarding the efficacy of transnasal humidified rapid insufflation ventilatory exchange (THRIVE) in tubeless anesthesia, especially in pediatric patients. This study aimed to evaluate the use of THRIVE for juvenile onset recurrent respiratory papillomatosis (JORRP) patients. METHODS: Twenty-eight children aged 2 to 12 years with JORRP, abnormal airways, and ASA physical status II–III that presented for surgical treatment under general anesthesia were included in this study. Each patient received 2 interventions in random order, with a 5-minute washout period between treatments: apnea without oxygen supplementation and apnea with THRIVE intervention. The primary outcome apnea time was defined as the duration from withdrawal of intubation to reintubation and resumption of controlled ventilation. The secondary outcomes were the mean transcutaneous carbon dioxide (tcco 2) increase rate, the minimum pulse oxygen saturation (Spo 2) during apnea, and the occurrence of unexpected adverse effects. RESULTS: The median apnea time in the THRIVE period was significantly longer than that in the control period (8.9 [8.6–9.4] vs 3.8 [3.4–4.3] minutes; mean difference [95% confidence interval (CI)], 5.0 [4.4–5.6]; P < .001) for all patients. The rate of CO2 change in the control period was higher than that in the THRIVE period both for patients aged 2 to 5 years old (6.29 [5.19–7.4] vs 3.22 [2.92–3.76] mm Hg min−1; mean difference [95% CI], 3.09 [2.27–3.67]; P < .001) and for patients aged 6 to 12 years old (4.76 [3.7–6.2] vs 3.38 [2.64–4.0] mm Hg min−1; mean difference [95% CI], 1.63 [0.75–2.56]; P < .001). The minimum Spo 2 was significantly higher in the THRIVE period than in the control period (mean difference [95% CI], 19.7 [14.8–22.6]; P < .001). CONCLUSIONS: Our findings demonstrate that THRIVE safely increased the apnea time among children with JORRP undergoing surgery and decreased the rate of carbon dioxide increase. THRIVE is clinically recommended as an airway management technique for tubeless anesthesia in apneic children.

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Section: Discussionmentioning

confidence: 69%

Transnasal Humidified Rapid Insufflation Ventilatory Exchange Augments Oxygenation in Children With Juvenile Onset Recurrent Respiratory Papillomatosis During Surgery: A Prospective Randomized Crossover Controlled Trial

Lei

et al. 2023

Anesthesia &Amp; Analgesia

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Oxygen concentration titration guided by oxygen reserve index during pediatric laryngeal surgery with high-flow nasal cannula oxygen: a randomized controlled trial

Li,

Liu,

Xiong

et al. 2024

J Anesth

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High-flow nasal cannula in nonlaser microlaryngoscopic surgery: a prospective study of 19 cases in a chinese population

Liu

Wang

et al. 2022

BMC Anesthesiol

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Background High-flow nasal cannula (HFNC) is a new type of oxygen therapy, but its application in surgery remains unclear, we tried to describe the application of HFNC in microlaryngoscopic surgery for the Chinese population. Methods Nineteen adults, American society of anesthesiology class (ASA) 1–2 patients with body mass index < 30 kg.m−2 underwent microlaryngoscopic surgery using HFNC for airway management. Outcomes included apnoea time, intraoperative oxygenation, carbon dioxide value, lactate value, and the relationship between the duration of apnoea time and carbon dioxide levels. Results A total of 19 patients underwent vocal cord tumor resection under a microlaryngoscope with HFNC as the sole method of ventilation. The mean age was 39.7 years old, and the mean BMI was 23.9 kg.m−2. The mean apnea time was 21.5 min. The SpO2 of 18 patients remained above 90%, and only 1 patient dropped to 88%. The average basal lactate and highest lactate value was 0.58 mmol. L−1 and 0.68 mmol.L−1. The difference between basal and highest lactate values was statistically significant (P < 0.05). The average highest PaCO2 value was 79.4 mmHg. The PaCO2 increased by 1.68 ± 0.12 mmHg every minute linearly. Conclusions In the case series we have observed that HFNC would be safe and effective oxygenation and ventilation technique for selected Chinese patients undergoing non-laser microlaryngoscopic surgery within 30 min. The tubeless technology reduces the complications of tracheal intubation and jet ventilation and clears the surgical field of vision. Trial registration Chinese Clinical Trial Registry (ChiCTR100049144).

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Transnasal Humidified Rapid-Insufflation Ventilatory Exchange in pediatric bronchoscopy: A prospective pilot study

Cited by 3 publications

References 3 publications

Transnasal Humidified Rapid Insufflation Ventilatory Exchange Augments Oxygenation in Children With Juvenile Onset Recurrent Respiratory Papillomatosis During Surgery: A Prospective Randomized Crossover Controlled Trial

Transnasal Humidified Rapid Insufflation Ventilatory Exchange Augments Oxygenation in Children With Juvenile Onset Recurrent Respiratory Papillomatosis During Surgery: A Prospective Randomized Crossover Controlled Trial

Oxygen concentration titration guided by oxygen reserve index during pediatric laryngeal surgery with high-flow nasal cannula oxygen: a randomized controlled trial

High-flow nasal cannula in nonlaser microlaryngoscopic surgery: a prospective study of 19 cases in a chinese population

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