High-Flow Nasal Cannula Oxygen Does Not Prevent Desaturation During Intubation

Despite adequate preoxygenation, desaturation is common during endotracheal intubation in patients with respiratory disease. The use of high-flow nasal cannula oxygenation has recently been proposed to increase oxygen saturation during intubation, but no randomized trials have previously been published.

Investigators enrolled 124 patients at six French intensive care units who required endotracheal intubation for hypoxemic respiratory failure. Patients were at high risk for desaturation, with PaO₂/FiO₂ <300 mm Hg, respiratory rate ≥30 breaths per minute, and FiO₂ requirement of ≥50%. Patients were preoxygenated for 4 minutes with either face-mask oxygen or high-flow nasal cannula oxygen, which delivers nearly 100% FiO₂ at 60 L/minute. Those …