Scholarlink

Objective <p>To assess the effect of transnasal humidified rapid insufflation ventilatory exchange (THRIVE) on regional cerebral oxygen saturation (rScO<sub>2</sub>) during general anesthesia induction in traumatic brain injury (TBI) emergency surgery.</p> Methods <p>In this prospective randomized trial, 63 TBI patients undergoing emergency intracranial hematoma removal were allocated to conventional mask ventilation group (<i>n</i> = 32; 8 L/min O2, FiO2 1.00) or THRIVE group (<i>n</i> = 31; 30–50 L/min O2, FiO2 1.00). Outcomes included rScO2, PaO2, PaCO2, hypoxemia incidence (SpO2 &lt; 95%), end-tidal CO2 (PETCO2), and Glasgow Outcome Scale (GOS) at discharge.</p> Results <p>After 10-min preoxygenation, the THRIVE group exhibited higher rScO<sub>2</sub> (surgical side: 70.9% ± 3.6% vs. 63.6% ± 2.8%; non-surgical: 79.1% ± 1.6% vs. 71.2% ± 2.7%; <i>P</i> &lt; 0.01), increased PaO<sub>2</sub> (450.23 ± 60.99 vs. 264.88 ± 49.33&#xa0;mmHg), and reduced PaCO<sub>2</sub> (37.81 ± 3.65 vs. 43.59 ± 3.76&#xa0;mmHg; <i>P</i> &lt; 0.01). During tracheal intubation, hypoxemia events, defined as SpO2 &lt; 95%, occurred in 0/31 patients (0%) in the THRIVE group versus 9/32 patients (28.1%) in the conventional ventilation group (<i>P</i> &lt; 0.01). PETCO<sub>2</sub> post-intubation was lower in the THRIVE group (43.10 ± 2.66 vs. 49.22 ± 3.31&#xa0;mmHg; <i>P</i> &lt; 0.01). Patients receiving THRIVE had a higher proportion of good neurological outcomes (GOS &gt; 3: 35.5% vs. <i>P</i> &lt; 0.05). ICU/hospital stay and gastric antrum cross-sectional area showed no intergroup differences.</p> Conclusion <p>THRIVE could significantly increase rScO<sub>2</sub> during anesthesia induction in TBI emergency surgery patients and improve their neurological functional prognosis.</p> <p><i>Trial registration</i> retrospectively registered; Chinese Clinical Trial Registry, www.chictr.org.cn, number ChiCTR 2300073951: Registered on June 26.2023.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Transnasal humidified rapid insufflation ventilatory exchange versus conventional facemask breathing for preoxygenation during anesthesia induction in TBI surgery: a randomized controlled trial

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年12月25日

查看全文
  • Xiaoping Chen,
  • Chen Yang,
  • Yue Zhao,
  • Ju Gao,
  • Yali Ge,
  • Yang Zhang

摘要

Objective

To assess the effect of transnasal humidified rapid insufflation ventilatory exchange (THRIVE) on regional cerebral oxygen saturation (rScO2) during general anesthesia induction in traumatic brain injury (TBI) emergency surgery.

Methods

In this prospective randomized trial, 63 TBI patients undergoing emergency intracranial hematoma removal were allocated to conventional mask ventilation group (n = 32; 8 L/min O2, FiO2 1.00) or THRIVE group (n = 31; 30–50 L/min O2, FiO2 1.00). Outcomes included rScO2, PaO2, PaCO2, hypoxemia incidence (SpO2 < 95%), end-tidal CO2 (PETCO2), and Glasgow Outcome Scale (GOS) at discharge.

Results

After 10-min preoxygenation, the THRIVE group exhibited higher rScO2 (surgical side: 70.9% ± 3.6% vs. 63.6% ± 2.8%; non-surgical: 79.1% ± 1.6% vs. 71.2% ± 2.7%; P < 0.01), increased PaO2 (450.23 ± 60.99 vs. 264.88 ± 49.33 mmHg), and reduced PaCO2 (37.81 ± 3.65 vs. 43.59 ± 3.76 mmHg; P < 0.01). During tracheal intubation, hypoxemia events, defined as SpO2 < 95%, occurred in 0/31 patients (0%) in the THRIVE group versus 9/32 patients (28.1%) in the conventional ventilation group (P < 0.01). PETCO2 post-intubation was lower in the THRIVE group (43.10 ± 2.66 vs. 49.22 ± 3.31 mmHg; P < 0.01). Patients receiving THRIVE had a higher proportion of good neurological outcomes (GOS > 3: 35.5% vs. P < 0.05). ICU/hospital stay and gastric antrum cross-sectional area showed no intergroup differences.

Conclusion

THRIVE could significantly increase rScO2 during anesthesia induction in TBI emergency surgery patients and improve their neurological functional prognosis.

Trial registration retrospectively registered; Chinese Clinical Trial Registry, www.chictr.org.cn, number ChiCTR 2300073951: Registered on June 26.2023.