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

作者全名：Zheng, Delai; Yao, Yi; Luo, Chuan; Yang, Yanhui; Chen, Bogang; Li, Nana; Wang, Yi

作者地址：[Zheng, Delai; Yao, Yi; Yang, Yanhui; Wang, Yi] Chongqing Med Univ, Neijiang Affiliated Hosp, Peoples Hosp Neijiang 1, Dept Cardiothorac Surg, Neijiang, Sichuan, Peoples R China; [Luo, Chuan; Chen, Bogang; Li, Nana] Chongqing Med Univ, Neijiang Affiliated Hosp, Peoples Hosp Neijiang 1, Dept Anesthesiol, Neijiang, Sichuan, Peoples R China

通信作者：Wang, Y (通讯作者)，Chongqing Med Univ, Neijiang Affiliated Hosp, Peoples Hosp Neijiang 1, Dept Cardiothorac Surg, Neijiang, Sichuan, Peoples R China.

来源：PLOS ONE

ESI学科分类：Multidisciplinary

WOS号：WOS:001214105000021

JCR分区：Q1

影响因子：2.9

年份：2024

卷号：19

期号：4

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结束页：　

文献类型：Article

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摘要：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 O-2 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 similar to 153.54mmHg, P = 0.02) and safe apnoea time (MD = 103.81s, 95% CI: 42.07 similar to 165.56s, P = 0.001) was longer in the THRIVE group. Besides, the incidence rate of O-2 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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