Transnasal High-Flow Humidified Oxygen for a Difficult Airway

A physiologic pharyngeal oxygen reservoir extends the safe apnea window.

Transnasal Humidified Rapid-Insufflation Ventilatory Exchange (THRIVE) is a technique for providing high-flow, positive-pressure, humidified oxygen via nasal cannula. When compared with traditional methods of apneic oxygenation, THRIVE has been shown to decrease the rate of rise of carbon dioxide during apnea.

In an observational, cross-sectional study, researchers in the U.K. used the THRIVE technique in 25 patients with known or anticipated difficult airways who were undergoing general anesthesia for otolaryngology procedures. With head elevation to 40 degrees, patients were pre-oxygenated at 70 L/minute for 10 minutes using a commercial device (OptiFlow) to deliver high-flow, humidified oxygen via a modified nasal cannula (). Af…

Reviewing Authors

R. Eleanor Anderson, MD

Disclosures

Nothing to disclose

R. Eleanor Anderson, MD

Disclosures

Nothing to disclose

Ron M. Walls, MD, FRCPC, FAAEM

Disclosures

Speaker's bureauAirway Management Education Center, LLC

EquityAirway Management Education Center, LLC

Grant / Research supportAgency for Health Care Research and Quality

Editorial boardsManual of Emergency Airway Management; Rosen's Emergency Medicine; UpToDate; Scientific American Medicine

Leadership positions in professional societiesAssociation of Academic Chairs in Emergency Medicine (President)

Ron M. Walls, MD, FRCPC, FAAEM

Disclosures

Speaker's bureauAirway Management Education Center, LLC

EquityAirway Management Education Center, LLC

Grant / Research supportAgency for Health Care Research and Quality

Editorial boardsManual of Emergency Airway Management; Rosen's Emergency Medicine; UpToDate; Scientific American Medicine

Leadership positions in professional societiesAssociation of Academic Chairs in Emergency Medicine (President)

Transnasal High-Flow Humidified Oxygen for a Difficult Airway

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Reviewing Authors