<scp>THRIVE</scp> – atelectasis, hypercarbia and consent

Ungureanu, N.; Radhakrishna, S.

doi:10.1111/anae.13118

Cited by 1 publication

(1 citation statement)

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“…The positive pressure effect increases with the rising flow rate, providing 1 cm H 2 O PEEP with a closed mouth and 0.5 cm H 2 O PEEP with an open mouth for every 10 L/min increase in flow rate [ 8 ]. The positive pressure effect opens the patient’s upper airway, reduces intrapulmonary shunts, and further enhances the patient’s oxygen reserve [ 9 ]. However, currently, there is no high-quality evidence elucidating the specific effectiveness of THRIVE during anesthesia induction.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of trans-nasal humidified rapid insufflation ventilatory exchange compared with standard facemask oxygenation for pre- and apneic oxygenation during anesthesia induction: A meta-analysis based on randomized controlled trials

Zheng,

Yao,

Luo

et al. 2024

PLoS ONE

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Purpose To further identify the effectiveness of trans-nasal humidified rapid insufflation ventilatory exchange (THRIVE) for pre- and apneic oxygenation during the anesthesia induction by comparison to facemask ventilation (FMV) based on current available evidence. Methods Medline, EMBASE, Web of Science, Cochrane Library and CNKI databases were searched from inception to December 22, 2023 for available randomized controlled trials (RCTs). Primary outcomes were PaO2 and PaCO2 after intubation and safe apnoea time. Secondary outcomes included the O2 desaturation, end expiratory carbon dioxide (EtCO2) and complications. The effect measures for continuous and categorical outcomes were separately the mean difference (MD) and relative risk (RR) with 95% confidence interval. Results Twelve RCTs with 403 patients in the THRIVE group and 401 patients in th FMV group were included. Pooled results demonstrated that the PaO2 after intubation was significantly higher (MD = 82.90mmHg, 95% CI: 12.25~153.54mmHg, P = 0.02) and safe apnoea time (MD = 103.81s, 95% CI: 42.07~165.56s, P = 0.001) was longer in the THRIVE group. Besides, the incidence rate of O2 desaturation (RR = 0.28, 95% CI: 0.12–0.66, P = 0.004) and gastric insufflation (RR = 0.26, 95% CI: 0.13–0.49, P<0.001) was significantly lower in the THRIVE group. Conclusion Based on current evidence, THRIVE manifested better effectiveness representing as improved oxygenation, prolonged safe apnoea time and decreased risk of complications compared to standard FMV in surgical patients. Therefore, THRIVE could be served as a novel and valuable oxygenation technology for patients during anesthesia induction.

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Section: Introductionmentioning

confidence: 99%