{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T06:06:08Z","timestamp":1768543568373,"version":"3.49.0"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T00:00:00Z","timestamp":1765238400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T00:00:00Z","timestamp":1768435200000},"content-version":"vor","delay-in-days":37,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"DOI":"10.1038\/s41598-025-31709-4","type":"journal-article","created":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T10:49:22Z","timestamp":1765277362000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Nasopharyngeal airway oxygenation enhances safe apnea time in patients at moderately high altitude: a randomized clinical trial"],"prefix":"10.1038","volume":"16","author":[{"given":"Huixing","family":"Liu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yeyue","family":"Gao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yaojun","family":"Lu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wangjun","family":"Dong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shen","family":"Sun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chen","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,12,9]]},"reference":[{"issue":"2","key":"31709_CR1","doi-asserted-by":"publisher","first-page":"507","DOI":"10.1213\/ANE.0000000000001589","volume":"124","author":"U Nimmagadda","year":"2017","unstructured":"Nimmagadda, U. et al. Preoxygenation: physiologic Basis, Benefits, and potential risks. Anesth. Analg. 124 (2), 507\u2013517. https:\/\/doi.org\/10.1213\/ANE.0000000000001589 (2017).","journal-title":"Anesth. Analg"},{"issue":"6","key":"31709_CR2","doi-asserted-by":"publisher","first-page":"827","DOI":"10.1093\/bja\/aev371","volume":"115","author":"C Frerk","year":"2015","unstructured":"Frerk, C. et al. Difficult airway society 2015 guidelines for management of unanticipated difficult intubation in adults. Br. J. Anaesth. 115 (6), 827\u2013848. https:\/\/doi.org\/10.1093\/bja\/aev371 (2015).","journal-title":"Br. J. Anaesth."},{"key":"31709_CR3","first-page":"7","volume":"25","author":"SQ Huang","year":"2009","unstructured":"Huang, S. Q. et al. Effect of oxygenation techniques on the safety period for tracheal intubation. J. Clin. Anesthesiol. 25, 7 (2009).","journal-title":"J. Clin. Anesthesiol"},{"issue":"4","key":"31709_CR4","doi-asserted-by":"publisher","first-page":"841","DOI":"10.1097\/00000542-200310000-00015","volume":"99","author":"JJ Pandit","year":"2003","unstructured":"Pandit, J. J. et al. Total oxygen uptake with two maximal breathing techniques and the tidal volume breathing technique: a physiologic study of preoxygenation. Anesthesiology 99 (4), 841\u2013846. https:\/\/doi.org\/10.1097\/00000542-200310000-00015 (2003).","journal-title":"Anesthesiology"},{"issue":"4","key":"31709_CR5","doi-asserted-by":"publisher","first-page":"543","DOI":"10.1007\/s00540-009-0787-7","volume":"23","author":"KB Leissner","year":"2009","unstructured":"Leissner, K. B. et al. Physiology and pathophysiology at high altitude: considerations for the anesthesiologist. J. Anesth. 23 (4), 543\u2013553. https:\/\/doi.org\/10.1007\/s00540-009-0787-7 (2009).","journal-title":"J. Anesth."},{"issue":"9","key":"31709_CR6","doi-asserted-by":"publisher","first-page":"1132","DOI":"10.1161\/CIRCULATIONAHA.106.624544","volume":"115","author":"D Penaloza","year":"2007","unstructured":"Penaloza, D. et al. The heart and pulmonary circulation at high altitudes: healthy Highlanders and chronic mountain sickness. Circulation 115 (9), 1132\u20131146. https:\/\/doi.org\/10.1161\/CIRCULATIONAHA.106.624544 (2007).","journal-title":"Circulation"},{"key":"31709_CR7","first-page":"8","volume":"42","author":"Jin","year":"2022","unstructured":"Jin et al. Comparison of safety apnea time during endotracheal intubation in patients from different altitudes:based on oxygen reserve index monitoring. Chin. J. Anesthesiol. 42, 8 (2022).","journal-title":"Chin. J. Anesthesiol"},{"issue":"12","key":"31709_CR8","doi-asserted-by":"publisher","first-page":"1097","DOI":"10.1213\/00000539-198412000-00008","volume":"63","author":"MF James","year":"1984","unstructured":"James, M. F. et al. Anesthetic considerations at moderate altitude. Anesth. Analg. 63 (12), 1097\u20131105 (1984).","journal-title":"Anesth. Analg"},{"issue":"4","key":"31709_CR9","doi-asserted-by":"publisher","first-page":"497","DOI":"10.1111\/anae.14565","volume":"74","author":"C Lyons","year":"2019","unstructured":"Lyons, C. et al. Uses and mechanisms of apnoeic oxygenation: a narrative review. Anaesthesia 74 (4), 497\u2013507. https:\/\/doi.org\/10.1111\/anae.14565 (2019).","journal-title":"Anaesthesia"},{"issue":"4","key":"31709_CR10","doi-asserted-by":"publisher","first-page":"610","DOI":"10.1093\/bja\/aex036","volume":"118","author":"IM Gustafsson","year":"2017","unstructured":"Gustafsson, I. M. et al. Apnoeic oxygenation in adults under general anaesthesia using transnasal humidified Rapid-Insufflation ventilatory exchange (THRIVE) - a physiological study. Br. J. Anaesth. 118 (4), 610\u2013617. https:\/\/doi.org\/10.1093\/bja\/aex036 (2017).","journal-title":"Br. J. Anaesth."},{"issue":"3","key":"31709_CR11","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1111\/anae.12923","volume":"70","author":"A Patel","year":"2015","unstructured":"Patel, A. et al. Transnasal humidified Rapid-Insufflation ventilatory exchange (THRIVE): a physiological method of increasing Apnoea time in patients with difficult airways. Anaesthesia 70 (3), 323\u2013329. https:\/\/doi.org\/10.1111\/anae.12923 (2015).","journal-title":"Anaesthesia"},{"issue":"6","key":"31709_CR12","doi-asserted-by":"publisher","first-page":"798","DOI":"10.1111\/anae.15277","volume":"76","author":"ZM Piosik","year":"2021","unstructured":"Piosik, Z. M. et al. Exploring the limits of prolonged Apnoea with high-flow nasal oxygen: an observational study. Anaesthesia 76 (6), 798\u2013804. https:\/\/doi.org\/10.1111\/anae.15277 (2021).","journal-title":"Anaesthesia"},{"issue":"1","key":"31709_CR13","doi-asserted-by":"publisher","first-page":"16325","DOI":"10.1038\/s41598-022-20717-3","volume":"12","author":"W Geng","year":"2022","unstructured":"Geng, W. et al. Role of modified nasopharyngeal oxygen therapy in apnoeic oxygenation under general anaesthesia: a single-centre, randomized controlled clinical study. Sci. Rep. 12 (1), 16325. https:\/\/doi.org\/10.1038\/s41598-022-20717-3 (2022).","journal-title":"Sci. Rep."},{"issue":"4","key":"31709_CR14","doi-asserted-by":"publisher","first-page":"1162","DOI":"10.1213\/ANE.0000000000001564","volume":"124","author":"A Heard","year":"2017","unstructured":"Heard, A. et al. Apneic oxygenation during prolonged laryngoscopy in obese patients: A Randomized, controlled trial of buccal RAE tube oxygen administration. Anesth. Analg. 124 (4), 1162\u20131167. https:\/\/doi.org\/10.1213\/ANE.0000000000001564 (2017).","journal-title":"Anesth. Analg"},{"issue":"7","key":"31709_CR15","first-page":"812","volume":"34","author":"GQ Geng","year":"2014","unstructured":"Geng, G. Q. et al. Effect of chronic anemia on duration of non-hypoxic apnea during tracheal intubation after induction of general anesthesia in female patients. Chin. J. Anesthesiol. 34(7), 812\u2013814 (2014).","journal-title":"Chin. J. Anesthesiol."},{"issue":"22","key":"31709_CR16","doi-asserted-by":"publisher","first-page":"6809","DOI":"10.3390\/jcm11226809","volume":"11","author":"WA Wetsch","year":"2022","unstructured":"Wetsch, W. A. et al. Identification of the optimal position of a nasal oxygen cannula for apneic oxygenation: A technical simulation. J. Clin. Med. 11 (22), 6809. https:\/\/doi.org\/10.3390\/jcm11226809 (2022).","journal-title":"J. Clin. Med."},{"issue":"3","key":"31709_CR17","doi-asserted-by":"publisher","first-page":"192","DOI":"10.3760\/cma.j.cn112137-20231012-00725","volume":"104","author":"LX Li","year":"2024","unstructured":"Li, L. X. et al. The ventilation efficacy and safety of new nasopharyngeal airway applied in left atrial appendage occlusion]. Zhonghua Yi Xue Za Zhi 104(3), 192\u2013197. https:\/\/doi.org\/10.3760\/cma.j.cn112137-20231012-00725 (2024).","journal-title":"Zhonghua Yi Xue Za Zhi"},{"issue":"5","key":"31709_CR18","doi-asserted-by":"publisher","first-page":"389","DOI":"10.5114\/ait.2020.101412","volume":"52","author":"HSE El-Ozairy","year":"2020","unstructured":"El-Ozairy, H. S. E. et al. Comparison between nasopharyngeal airway and laryngeal mask airway in blepharoplasty under general anaesthesia. A randomized controlled trial. Anaesthesiol. Intensive Ther. 52 (5), 389\u2013394. https:\/\/doi.org\/10.5114\/ait.2020.101412 (2020).","journal-title":"Anaesthesiol. Intensive Ther."},{"issue":"5","key":"31709_CR19","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1111\/j.1365-2044.2006.04610.x","volume":"61","author":"SK Taha","year":"2006","unstructured":"Taha, S. K. et al. Nasopharyngeal oxygen insufflation following pre-oxygenation using the four deep breath technique. Anaesthesia 61 (5), 427\u2013430. https:\/\/doi.org\/10.1111\/j.1365-2044.2006.04610.x (2006).","journal-title":"Anaesthesia"},{"issue":"11","key":"31709_CR20","doi-asserted-by":"publisher","first-page":"897","DOI":"10.4103\/ija.IJA_232_17","volume":"61","author":"N Sahay","year":"2017","unstructured":"Sahay, N. et al. Effect of nasal oxygen supplementation during Apnoea of intubation on arterial oxygen levels: A prospective randomised controlled trial. Indian J. Anaesth. 61 (11), 897\u2013902. https:\/\/doi.org\/10.4103\/ija.IJA_232_17 (2017).","journal-title":"Indian J. Anaesth."},{"issue":"1","key":"31709_CR21","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1097\/ALN.0000000000004025","volume":"136","author":"T Riva","year":"2022","unstructured":"Riva, T. et al. Carbon dioxide changes during High-flow nasal oxygenation in apneic patients: A Single-center randomized controlled noninferiority trial. Anesthesiology 136 (1), 82\u201392. https:\/\/doi.org\/10.1097\/ALN.0000000000004025 (2022).","journal-title":"Anesthesiology"},{"issue":"3","key":"31709_CR22","doi-asserted-by":"publisher","first-page":"366","DOI":"10.4103\/joacp.joacp_392_21","volume":"39","author":"R Preya","year":"2023","unstructured":"Preya, R. et al. Effectiveness of face mask only oxygenation and apnoeic oxygenation in addition to face mask in sustaining PaO2 during rapid sequence induction - A randomized control trial. J. Anaesthesiol. Clin. Pharmacol. 39 (3), 366\u2013371. https:\/\/doi.org\/10.4103\/joacp.joacp_392_21 (2023).","journal-title":"J. Anaesthesiol. Clin. Pharmacol."},{"issue":"3","key":"31709_CR23","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1016\/j.annemergmed.2011.10.002","volume":"59","author":"SD Weingart","year":"2012","unstructured":"Weingart, S. D. et al. Preoxygenation and prevention of desaturation during emergency airway management. Ann. Emerg. Med. 59 (3), 165\u201375e1. https:\/\/doi.org\/10.1016\/j.annemergmed.2011.10.002 (2012).","journal-title":"Ann. Emerg. Med."},{"issue":"2","key":"31709_CR24","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1177\/0194599813486248","volume":"149","author":"B Rudlof","year":"2013","unstructured":"Rudlof, B. et al. Use of apneic oxygenation for the performance of pan-endoscopy. Otolaryngol. Head Neck Surg. 149 (2), 235\u2013239. https:\/\/doi.org\/10.1177\/0194599813486248 (2013).","journal-title":"Otolaryngol. Head Neck Surg."},{"issue":"6","key":"31709_CR25","doi-asserted-by":"publisher","first-page":"430","DOI":"10.1097\/EJA.0000000000001989","volume":"41","author":"A Sj\u00f6blom","year":"2024","unstructured":"Sj\u00f6blom, A. et al. Comparison of preoxygenation using a tight facemask, humidified high-flow nasal oxygen and a standard nasal cannula - a volunteer, randomised, crossover study. Eur. J. Anaesthesiol. 41 (6), 430\u2013437. https:\/\/doi.org\/10.1097\/EJA.0000000000001989 (2024).","journal-title":"Eur. J. Anaesthesiol."},{"issue":"2","key":"31709_CR26","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1007\/s00540-013-1714-5","volume":"28","author":"AA Kolettas","year":"2014","unstructured":"Kolettas, A. A. et al. Influence of apneic oxygenation on cardiorespiratory system homeostasis. J. Anesth. 28 (2), 172\u2013179. https:\/\/doi.org\/10.1007\/s00540-013-1714-5 (2014).","journal-title":"J. Anesth."},{"issue":"1","key":"31709_CR27","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1213\/ANE.0000000000005002","volume":"133","author":"AWG Booth","year":"2021","unstructured":"Booth, A. W. G. et al. The effect of High-Flow nasal oxygen on carbon dioxide accumulation in apneic or spontaneously breathing adults during airway surgery: A Randomized-Controlled trial. Anesth. Analg. 133 (1), 133\u2013141. https:\/\/doi.org\/10.1213\/ANE.0000000000005002 (2021).","journal-title":"Anesth. Analg"},{"issue":"5","key":"31709_CR28","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1007\/s12630-017-0835-y","volume":"64","author":"DT Wong","year":"2017","unstructured":"Wong, D. T., Yee, A. J., Leong, S. M. & Chung, F. The effectiveness of apneic oxygenation during tracheal intubation in various clinical settings: a narrative review [published correction appears in. Can. J. Anaesth. 64 (5), 557. https:\/\/doi.org\/10.1007\/s12630-017-0835-y (2017).","journal-title":"Can. J. Anaesth."},{"issue":"2","key":"31709_CR29","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1007\/s00540-011-1098-3","volume":"25","author":"Ramkumar","year":"2011","unstructured":"Ramkumar Preoxygenation with 20 head-up Tilt provides longer duration of non-hypoxic apnea than conventional preoxygenation in nork-obese healthy adults[J]. J. Anesth. 25 (2), 189\u2013194 (2011).","journal-title":"J. Anesth."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-31709-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-31709-4","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-31709-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T12:18:10Z","timestamp":1768479490000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-31709-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,9]]},"references-count":29,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["31709"],"URL":"https:\/\/doi.org\/10.1038\/s41598-025-31709-4","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,9]]},"assertion":[{"value":"10 October 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 December 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 December 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"2021"}}