{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T10:48:25Z","timestamp":1787654905849,"version":"build-2736575974"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"27","license":[{"start":{"date-parts":[[2022,7,8]],"date-time":"2022-07-08T00:00:00Z","timestamp":1657238400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:p>The use of high-flow nasal oxygen is gaining popularity in apneic and spontaneously breathing adult patients during anesthesia. This prospective observational study evaluated the effect of high-flow nasal oxygen in maintaining adequate oxygenation and ventilation in spontaneously breathing pediatric patients with dynamic airway obstruction, undergoing tubeless airway surgery.<\/jats:p>\n          <jats:p>Oxygenation was provided via an age-appropriate, high-flow nasal cannula at a flow rate of 2 L kg<jats:sup>\u22121<\/jats:sup> min<jats:sup>\u22121<\/jats:sup>. Propofol and remifentanil were used to maintain anesthesia while preserving spontaneous respiration. We sought to determine the incidence and risk factors of rescue ventilation. Rescue ventilation with a face mask was performed when the pulse oximetry oxygen saturation was &lt;90% or transcutaneous carbon dioxide was &gt;80 mm Hg.<\/jats:p>\n          <jats:p>In total, 27 patients were included in the final analysis. Median (interquartile range) of pulse oximetry and transcutaneous carbon dioxide were 100% (99%\u2013100%) and 58.4 mm Hg (51.4\u201370.3 mm Hg), respectively. Altogether, 9 (33.3%) patients needed rescue ventilation during anesthesia. Of these, 7 patients (25.9%) developed oxygen desaturation (&lt;90%) and 2 patients (7.4%) developed hypercarbia. Patients who required rescue ventilation were significantly younger (8.2 vs 28.8 months, <jats:italic toggle=\"yes\">P<\/jats:italic> = .02) and required a longer anesthesia time (55.7 vs 41.0 minutes, <jats:italic toggle=\"yes\">P<\/jats:italic> = .04) than those who did not.<\/jats:p>\n          <jats:p>In conclusion, High-flow nasal oxygen is an alternative technique to maintain oxygenation in children undergoing airway surgeries. However, younger age and longer anesthesia time are significant risk factors leading to the requirement of rescue ventilation in these patients. Further studies with large sample size are required for clinical application of these techniques.<\/jats:p>","DOI":"10.1097\/md.0000000000029520","type":"journal-article","created":{"date-parts":[[2022,7,8]],"date-time":"2022-07-08T12:25:39Z","timestamp":1657283139000},"page":"e29520","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":11,"title":["Use of high-flow nasal oxygen in spontaneously breathing pediatric patients undergoing tubeless airway surgery: A prospective observational study"],"prefix":"10.1097","volume":"101","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0697-1935","authenticated-orcid":false,"given":"Eun-Hee","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Pain medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang-Hwan","family":"Ji","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji-Hyun","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin-Tae","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young-Eun","family":"Jang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seong-Keun","family":"Kwon","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2661-7944","authenticated-orcid":false,"given":"Hee-Soo","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2022,7,8]]},"reference":[{"issue":"1 Pt 1","key":"R1-20250504","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1177\/000348948709600107","article-title":"Intravenous anesthesia and jet ventilation for laser microlaryngeal surgery.","volume":"96","author":"Gussack","year":"1987","journal-title":"Ann Otol Rhinol Laryngol"},{"key":"R2-20250504","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1183\/09031936.02.00226002","article-title":"Measurement of lung volume and ventilation distribution with an ultrasonic flow meter in healthy infants.","volume":"20","author":"Schibler","year":"2002","journal-title":"Eur Respir J"},{"key":"R3-20250504","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1378\/chest.105.4.1061","article-title":"Effect of low flow and high flow oxygen delivery on exercise tolerance and sensation of dyspnea. 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