{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:32:14Z","timestamp":1753878734873,"version":"3.41.2"},"reference-count":19,"publisher":"Wiley","license":[{"start":{"date-parts":[[2024,8,28]],"date-time":"2024-08-28T00:00:00Z","timestamp":1724803200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003625","name":"Ministry of Health and Welfare","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003625","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Anesthesia"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>High\u2010flow nasal oxygenation is reported to prolong duration of apnea while maintaining adequate oxygen saturation with the mouth closed. Also, buccal oxygenation is known to have similar effects in obese adults. We compared the effect of these two methods on prolongation of acceptable apnea time in pediatric patients with their mouth open.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Thirty\u2010eight patients, aged 0\u201310\u2009years were randomly allocated to either the high\u2010flow nasal oxygenation group (<jats:italic>n<\/jats:italic>\u2009=\u200917) or the buccal oxygenation group (<jats:italic>n<\/jats:italic>\u2009=\u200921). After induction of anesthesia including neuromuscular blockade, manual ventilation was initiated until the expiratory oxygen concentration reached 90%. Subsequently, ventilation was paused, and the patient's head was extended, and mouth was opened. The HFNO group received 2\u2009L\u00b7min<jats:sup>\u22121<\/jats:sup>\u00b7kg<jats:sup>\u22121<\/jats:sup> of oxygen, and the BO group received 0.5\u2009L\u00b7min<jats:sup>\u22121<\/jats:sup>\u00b7kg<jats:sup>\u22121<\/jats:sup> of oxygen. We set a target apnea time according to previous literature. When the apnea time reached the target, we defined the case as \u201csuccess\u201d in prolongation of safe apnea time and resumed ventilation. When the pulse oximetry decreased to 92% before the target apnea time, it was recorded as \u201cfailure\u201d and rescue ventilation was given.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The success rate of safe apnea prolongation was 100% in the high\u2010flow nasal oxygenation group compared to 76% in the buccal oxygenation group (<jats:italic>p<\/jats:italic>\u2009=\u2009.04). Oxygen reserve index, end\u2010tidal or transcutaneous carbon dioxide partial pressure, and pulse oximetry did not differ between groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>High\u2010flow nasal oxygenation is effective in maintaining appropriate arterial oxygen saturation during apnea even in children with their mouth open and is superior to buccal oxygenation. Buccal oxygenation may be a good alternative when high\u2010flow nasal oxygenation is not available.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pan.14982","type":"journal-article","created":{"date-parts":[[2024,8,28]],"date-time":"2024-08-28T08:19:37Z","timestamp":1724833177000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of high\u2010flow nasal and buccal oxygenation on safe apnea time in children with open mouth: A randomized controlled trial"],"prefix":"10.1111","author":[{"given":"Sang\u2010Hwan","family":"Ji","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":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jung\u2010Bin","family":"Park","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":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pyoyoon","family":"Kang","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":[{"role":"author","vocabulary":"crossref"}]},{"given":"Young\u2010Eun","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":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3738-0081","authenticated-orcid":false,"given":"Eun\u2010Hee","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":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ji\u2010Hyun","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":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2661-7944","authenticated-orcid":false,"given":"Hee\u2010Soo","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":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jin\u2010Tae","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine Seoul National University Hospital, Seoul National University College 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