Efficacy and Safety of Using High-Flow Nasal Oxygenation in Patients Undergoing Rapid Sequence Intubation

Raineri, Santi Maurizio; Cortegiani, Andrea; Accurso, Giuseppe; Procaccianti, Claudia; Vitale, Filippo; Caruso, Sabrina; Giarratano, Antonino; Gregoretti, Cesare

doi:10.5152/tjar.2017.47048

Cited by 17 publications

(15 citation statements)

References 27 publications

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“…Seven studies reported gastric insufflation or aspiration, either directly or when included as a “moderate complication” (24, 25, 27, 28, 30, 33, 35). In general, based on very low-quality evidence, it appears as though HFNO does not affect aspiration risk.…”

Section: Resultsmentioning

confidence: 99%

“…Eight studies reported rates of cardiac arrest (or severe cardiovascular collapse) or severe complications, including cardiac arrest (24, 25, 27, 28, 30, 31, 33, 34). In general, all are very low quality of evidence; therefore, no conclusions could be drawn.…”

Section: Resultsmentioning

confidence: 99%

“…However, concerns exist that continuous oxygen flow of 40-60 L throughout the respiratory cycle may lead to gastric insufflation, which may increase the risk of regurgitation and aspiration. Thirteen studies were included to address this question (24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36).…”

Section: Recommendationmentioning

confidence: 99%

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Society of Critical Care Medicine Clinical Practice Guidelines for Rapid Sequence Intubation in the Critically Ill Adult Patient

Acquisto,

Mosier,

Bittner

et al. 2023

Critical Care Medicine

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RATIONALE: Controversies and practice variations exist related to the pharmacologic and nonpharmacologic management of the airway during rapid sequence intubation (RSI). OBJECTIVES: To develop evidence-based recommendations on pharmacologic and nonpharmacologic topics related to RSI. DESIGN: A guideline panel of 20 Society of Critical Care Medicine members with experience with RSI and emergency airway management met virtually at least monthly from the panel’s inception in 2018 through 2020 and face-to-face at the 2020 Critical Care Congress. The guideline panel included pharmacists, physicians, a nurse practitioner, and a respiratory therapist with experience in emergency medicine, critical care medicine, anesthesiology, and prehospital medicine; consultation with a methodologist and librarian was available. A formal conflict of interest policy was followed and enforced throughout the guidelines-development process. METHODS: Panelists created Population, Intervention, Comparison, and Outcome (PICO) questions and voted to select the most clinically relevant questions for inclusion in the guideline. Each question was assigned to a pair of panelists, who refined the PICO wording and reviewed the best available evidence using predetermined search terms. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) framework was used throughout and recommendations of “strong” or “conditional” were made for each PICO question based on quality of evidence and panel consensus. Recommendations were provided when evidence was actionable; suggestions, when evidence was equivocal; and best practice statements, when the benefits of the intervention outweighed the risks, but direct evidence to support the intervention did not exist. RESULTS: From the original 35 proposed PICO questions, 10 were selected. The RSI guideline panel issued one recommendation (strong, low-quality evidence), seven suggestions (all conditional recommendations with moderate-, low-, or very low-quality evidence), and two best practice statements. The panel made two suggestions for a single PICO question and did not make any suggestions for one PICO question due to lack of evidence. CONCLUSIONS: Using GRADE principles, the interdisciplinary panel found substantial agreement with respect to the evidence supporting recommendations for RSI. The panel also identified literature gaps that might be addressed by future research.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Society of Critical Care Medicine Clinical Practice Guidelines for Rapid Sequence Intubation in the Critically Ill Adult Patient

Acquisto,

Mosier,

Bittner

et al. 2023

Critical Care Medicine

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“…Endotracheal intubation (ETI) is a potentially life-threatening procedure in the operating room, especially in critically ill patients who require surgery. ETI may expose these patients to the risk of severe desaturation, eventually resulting in cardiac arrest and death [ 51 – 53 ].…”

Section: Main Textmentioning

confidence: 99%

“…Raineri et al assessed the efficacy and safety of HFNT in 45 patients receiving RSI for urgent abdominal surgery. HFNT at 60 L/min and FiO 2 of 1 was used for 4 min prior to induction and maintained until ETI [ 53 ]. Heart rate, SpO 2 , and mean arterial pressure were assessed at baseline (T0), after 4 min on HFNT (T1), during laryngoscopy (T2) and at the time of ETI (T3).…”

Section: Main Textmentioning

confidence: 99%

High flow nasal therapy in perioperative medicine: from operating room to general ward

et al. 2018

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BackgroundHigh flow nasal therapy (HFNT) is a technique in which humidified and heated gas is delivered to the airways through the nose via small nasal prongs at flows that are higher than the rates generally applied during conventional oxygen therapy. The delivered high flow rates combine mixtures of air and oxygen and enable different inspired oxygen fractions ranging from 0.21 to 1. HFNT is increasingly used in critically ill adult patients, especially hypoxemic patients in different clinical settings.Main bodyNoninvasive ventilation delivers positive pressure (end-expiratory and inspiratory pressures or continuous positive airway pressure) via different external interfaces. In contrast, HFNT produces different physiological effects that are only partially linked to the generation of expiratory positive airway pressure. HFNT and noninvasive ventilation (NIV) are interesting non-invasive supports in perioperative medicine. HFNT exhibits some advantages compared to NIV because HFNT is easier to apply and requires a lower nursing workload. Tolerance of HFNT remains a matter of intense debate, and it may be related to selected parameters. Patients receiving HFNT and their respiratory patterns should be closely monitored to avoid delays in intubation despite correct oxygenation parameters.ConclusionHFNT seems to be an interesting noninvasive support in perioperative medicine. The present review provides anesthesiologists with an overview of current evidence and practical advice on the application of HFNT in perioperative medicine in adult patients.

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Clinical Applications of High-Flow Nasal Cannula during Intubation and Weaning from Mechanical Ventilation

Battilana

Serano

Iovino

et al. 2021

High Flow Nasal Cannula

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Efficacy and Safety of Using High-Flow Nasal Oxygenation in Patients Undergoing Rapid Sequence Intubation

Cited by 17 publications

References 27 publications

Society of Critical Care Medicine Clinical Practice Guidelines for Rapid Sequence Intubation in the Critically Ill Adult Patient

Society of Critical Care Medicine Clinical Practice Guidelines for Rapid Sequence Intubation in the Critically Ill Adult Patient

High flow nasal therapy in perioperative medicine: from operating room to general ward

Clinical Applications of High-Flow Nasal Cannula during Intubation and Weaning from Mechanical Ventilation

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