{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:59:04Z","timestamp":1787068744613,"version":"build-2736575974"},"reference-count":33,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2020,2,20]],"date-time":"2020-02-20T00:00:00Z","timestamp":1582156800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"This study was supported by research grant (to Vladimir Nekhendzy) from Fisher & Paykel Healthcare, Auckland, New Zealand, a manufacturer of Optiflow system."}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Transnasal humidified rapid\u2010insufflation ventilatory exchange (THRIVE) is an intraoperative ventilatory technique that allows avoidance of tracheal intubation (TI) or jet ventilation (JV) in selected laryngologic surgical cases. Unimpeded access to all parts of the glottis may improve surgical precision, decrease operative time, and potentially improve patient outcomes. The objective of this prospective, randomized, patient\u2010blinded, 2\u2010arm parallel pilot trial was to investigate the safety and efficacy of THRIVE use for adult patients undergoing nonlaser laryngologic surgery of short\u2010to\u2010intermediate duration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Twenty adult, American society of anesthesiology class 1\u20103 patients with body mass index (BMI)\u2009&lt;\u200935\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      were randomly assigned to either an experimental THRIVE group or active comparator conventional ventilation group (TI or supraglottic high\u2010frequency JV [SHFJV]). Primary outcomes included intraoperative oxygenation, anesthesia awakening\/extubation time, time to laryngoscopic suspension, number of intraoperative suspension adjustments, and operative time. Secondary patient outcomes including postanesthesia and functional patient recovery were investigated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared to TI\/SHFJV, THRIVE use was associated with significantly lower intraoperative oxygenation (SpO\n                      <jats:sub>2<\/jats:sub>\n                      93.0\u2009\u00b1\u20095.6% vs. 98.7\u2009\u00b1\u20091.6%), shorter time to suspension (1.8\u2009\u00b1\u20091.1\u2009minutes vs. 4.3\u2009\u00b1\u20092.1\u2009minutes), fewer suspension adjustments (0.4\u2009\u00b1\u20090.5 vs. 1.7\u2009\u00b1\u20090.9), and lower postoperative pain scores on recovery room admission (1.3\u2009\u00b1\u20091.9 vs. 3.7\u2009\u00b1\u20092.9) and discharge (0.9\u2009\u00b1\u20091.3 vs. 2.7\u2009\u00b1\u20091.8). The study was underpowered to detect other possible outcome differences.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We confirm the safe intraoperative oxygenation profile of THRIVE for selected patients undergoing nonlaser laryngologic surgery of short\u2010to\u2010intermediate duration. THRIVE facilitated surgical exposure and improved early patient recovery, suggesting a potential economic benefit for outpatient laryngologic procedures. The results of this exploratory study provide a framework for designing future adequately powered THRIVE trials.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Register<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                      (NCT03091179).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>\n                      II\n                      <jats:italic>Laryngoscope<\/jats:italic>\n                      , 2020\n                    <\/jats:p>\n                  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