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| Content Provider | frontiers |
|---|---|
| Author | Chen, Lingke Yang, Liu Tian, Weitian Zhang, Xiao Zhao, Yanhua Huang, Lili Tian, Jie Zhang, Jiaqiang Wu, Jiangxia Yu, Weifeng Su, Diansan |
| Abstract | Background: Transnasal humidified rapid insufflation ventilatory exchange (THRIVE) was used to extend the safe apnea time. However, THRIVE is only effective in patients with airway opening. Nasopharyngeal airway (NPA) is a simple device that can help to keep airway opening. This study aimed to investigate the noninferiority of NPA to jaw thrust for airway opening during anesthesia-induced apnea. Methods: This was a prospective randomized single-blinded noninferiority clinical trial on the use of THRIVE in patients with anesthesia-induced apnea. Participants were randomly allocated to receive NPA or jaw thrust. The primary outcomes were PaO2 and PaCO2 at 20 minutes after apnea, with noninferiority margin criteria of −6.67 and 0.67 kPa, respectively. Results: A total of 123 patients completed the trial: 61 in the NPA group and 62 in the jaw thrust group. PaO2 at 20 min after apnea was 42.9 ± 14.0 kPa in the NPA group and 42.7 ± 13.6 kPa in the jaw thrust group. The difference between these two means was 0.25 kPa (95% CI, −3.87–4.37 kPa). Since the lower boundary of the 95% CI was >−6.67 kPa, noninferiority was established because higher PO2 is better. PaCO2 at 20 min after apnea was 10.74 ± 1.09 kPa in the NPA group and 10.54 ± 1.18 kPa in the jaw thrust group. The difference between the two means was 0.19 kPa (95% CI, −0.14 to 0.53 kPa). Since the upper boundary of the 95% CI was <0.67 kPa, noninferiority was established because lower PCO2 is better. No patient had a SpO2 <90% during apnea. Conclusion: When THRIVE was applied during anesthesia-induced apnea, NPA placement kept airway opening and was noninferior to jaw thrust in terms of its effects on PaO2 and PaCO2 at 20 minutes after apnea. Clinical trial registration: ClinicalTrials.gov (NCT03741998) |
| ISSN | 2296858X |
| DOI | 10.3389/fmed.2020.577891 |
| Volume Number | 7 |
| Journal | Frontiers in Medicine |
| Language | English |
| Publisher Date | 2020-11-27 |
| Access Restriction | Open |
| Subject Keyword | Arterial blood gas General anaesthesia Apnoea oxygenation Nasopharyngeal airway Thrive |
| Content Type | Text |
| Resource Type | Article |
| Subject | Medicine |
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