{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T05:44:02Z","timestamp":1769924642664,"version":"3.49.0"},"reference-count":23,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,12,21]],"date-time":"2023-12-21T00:00:00Z","timestamp":1703116800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100001424","name":"American Liver Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001424","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004359","name":"Vetenskapsr\u00e5det","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Patients suffering from major traumatic injuries frequently require emergency anaesthesia. Due to often compromised physiology and the time\u2010sensitive management, trauma patients may be more prone to desaturate during induction of anaesthesia. We hypothesised that pre\u2010oxygenation using high\u2010flow nasal oxygen would decrease the risk of desaturation during induction of anaesthesia in trauma patients and the study therefore aimed to compare the frequency of desaturation when pre\u2010oxygenation was performed with high\u2010flow nasal oxygen or a traditional facemask.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This exploratory, prospective, before\u2010and\u2010after study was conducted at the Karolinska University Hospital, Sweden. Adult (\u226518\u2009years of age) patients suffering major traumatic injuries needing emergency anaesthesia were included around the clock. Patients were pre\u2010oxygenated using a tight\u2010fitting facemask during the first nine months of enrollment. High\u2010flow nasal oxygen was then introduced as a method for pre\u2010oxygenation of trauma patients. The primary outcome was the proportion of patients desaturating &lt;93% during induction of anaesthesia, assessed from the start of pre\u2010oxygenation until one minute after intubation. Secondary outcomes included perceived difficulty of pre\u2010oxygenation among anaesthetists (assessed on a scale between 1 and 10) and safety outcomes, such as incidence of regurgitations and intracranial gas (assessed radiologically).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Data from 96 patients were analysed. Facemask pre\u2010oxygenation was performed in 66 patients, while 30 patients were pre\u2010oxygenated with high\u2010flow nasal oxygen. The most frequent trauma mechanisms were stabbing injuries (<jats:italic>n<\/jats:italic>\u2009=\u200934 (35%)) and fall injuries (<jats:italic>n<\/jats:italic>\u2009=\u200921 (22%)). There were no differences in patient characteristics between the groups. Eight (12%) versus three (10%) patients desaturated &lt;93% in the facemask and high\u2010flow nasal oxygen group respectively, OR 0.81 (95% CI 0.20\u20133.28), <jats:italic>p<\/jats:italic>\u2009=\u2009.76. Anaesthetists assessed pre\u2010oxygenation using high\u2010flow nasal oxygen as easier compared to facemask pre\u2010oxygenation. No patient in any group showed signs of regurgitation. Among patients with facial or skull fractures requiring anaesthesia before radiology was performed, intracranial gas was seen in four (40%) patients pre\u2010oxygenated with a facemask and in no patient pre\u2010oxygenated with HFNO (<jats:italic>p<\/jats:italic>\u2009=\u2009.23).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In this prospective study investigating trauma patients undergoing emergency anaesthesia, we could not see any difference in the number of patients desaturating when pre\u2010oxygenation was performed with high\u2010flow nasal oxygen compared to a tight\u2010fitting facemask. Pre\u2010oxygenation using high\u2010flow nasal oxygen was assessed as easier compared to facemask pre\u2010oxygenation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.14368","type":"journal-article","created":{"date-parts":[[2023,12,22]],"date-time":"2023-12-22T04:43:40Z","timestamp":1703220220000},"page":"447-456","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Pre\u2010oxygenation using high\u2010flow nasal oxygen versus tight facemask in trauma patients undergoing emergency anaesthesia"],"prefix":"10.1111","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5526-4498","authenticated-orcid":false,"given":"Albin","family":"Sj\u00f6blom","sequence":"first","affiliation":[{"name":"Department of Perioperative Medicine and Intensive Care Karolinska University Hospital  Stockholm Sweden"},{"name":"Department of Physiology and Pharmacology, Section for Anesthesiology and Intensive Care Medicine Karolinska Institutet  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Magnus","family":"Hedberg","sequence":"additional","affiliation":[{"name":"Department of Perioperative Medicine and Intensive Care Karolinska University Hospital  Stockholm Sweden"},{"name":"Department of Physiology and Pharmacology, Section for Anesthesiology and Intensive Care Medicine Karolinska Institutet  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anders","family":"Gille","sequence":"additional","affiliation":[{"name":"Department of Perioperative Medicine and Intensive Care Karolinska University Hospital  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andres","family":"Guerra","sequence":"additional","affiliation":[{"name":"Medical school Karolinska Institutet  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vilde","family":"Aanesen","sequence":"additional","affiliation":[{"name":"Medical school Karolinska Institutet  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ida\u2010Maria","family":"Forsberg","sequence":"additional","affiliation":[{"name":"Department of Perioperative Medicine and Intensive Care Karolinska University Hospital  Stockholm Sweden"},{"name":"Department of Physiology and Pharmacology, Section for Anesthesiology and Intensive Care Medicine Karolinska Institutet  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Malin Jonsson","family":"Fagerlund","sequence":"additional","affiliation":[{"name":"Department of Perioperative Medicine and Intensive Care Karolinska University Hospital  Stockholm Sweden"},{"name":"Department of Physiology and Pharmacology, Section for Anesthesiology and Intensive Care Medicine Karolinska Institutet  Stockholm 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