{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T20:35:01Z","timestamp":1784666101011,"version":"3.55.0"},"reference-count":40,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2023,10,11]],"date-time":"2023-10-11T00:00:00Z","timestamp":1696982400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Anaesth Intensive Care"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:p>Prevention of arterial oxygen desaturation during anaesthesia with high-flow nasal oxygen (HFNO) has gained greater acceptance for a widening range of procedures. However, during HFNO use there remains the potential for development of significant anaesthesia-associated apnoea or hypoventilation and the possibility of hypercarbia, with harmful cardiovascular or neurological sequelae. The aim of this study was to determine whether any HFNO-related hypercarbia adverse incidents had been reported on webAIRS, an online database of adverse anaesthesia-related incidents. Two relevant reports were identified of complications due to marked hypercarbia during HFNO use to maintain oxygenation. In both reports, HFNO and total intravenous anaesthesia were used during endoscopic procedures through the upper airway. In both, the extent of hypoventilation went undetected during HFNO use. An ensuing cardiac arrest was reported in one report, ascribed to acute hypercarbia-induced exacerbation of the patient\u2019s pre-existing pulmonary hypertension. In the other report, hypercarbia led to a prolonged duration of decreased level of consciousness post procedure, requiring ventilatory support. During the search, an additional 11 reports of postoperative hypercarbia-associated sedation were identified, unrelated to HFNO. In these additional reports an extended duration of severe acute hypercarbia led to sedation or loss of consciousness, consistent with the known effects of hypercarbia on consciousness. These 13 reports highlight the potential dangers of unrecognised and untreated hypercarbia, even if adequate oxygenation is maintained.<\/jats:p>","DOI":"10.1177\/0310057x231198257","type":"journal-article","created":{"date-parts":[[2023,10,11]],"date-time":"2023-10-11T06:33:14Z","timestamp":1697005994000},"page":"400-407","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":9,"title":["Hypercarbia and high-flow nasal oxygen use during anaesthesia \u2013 risking a failure to thrive?"],"prefix":"10.1177","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6640-6714","authenticated-orcid":false,"given":"Gavin G","family":"Pattullo","sequence":"first","affiliation":[{"name":"North Shore Private Hospital, St. Leonards, Sydney, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin D","family":"Culwick","sequence":"additional","affiliation":[{"name":"Australian and New Zealand Tripartite Anaesthesia Data Committee, Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8804-4168","authenticated-orcid":false,"given":"Yasmin","family":"Endlich","sequence":"additional","affiliation":[{"name":"Australian and New Zealand Tripartite Anaesthesia Data Committee, Melbourne, Australia"},{"name":"The University of Adelaide, Adelaide, Australia"},{"name":"Department of Anaesthesia, Royal Adelaide Hospital, Adelaide, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ross D","family":"MacPherson","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Pain Management, Royal North Shore Hospital, St. Leonards, Sydney, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,10,11]]},"reference":[{"key":"bibr1-0310057X231198257","doi-asserted-by":"publisher","DOI":"10.1111\/anae.12923"},{"key":"bibr2-0310057X231198257","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000004025"},{"key":"bibr3-0310057X231198257","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2017.12.017"},{"key":"bibr4-0310057X231198257","doi-asserted-by":"publisher","DOI":"10.1186\/s40001-022-00661-8"},{"key":"bibr5-0310057X231198257","doi-asserted-by":"publisher","DOI":"10.1111\/anae.15527"},{"key":"bibr6-0310057X231198257","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aex036"},{"key":"bibr7-0310057X231198257","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2018.10.026"},{"key":"bibr8-0310057X231198257","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000004837"},{"key":"bibr9-0310057X231198257","first-page":"136","volume-title":"Nunn and Lumb\u2019s applied respiratory physiology","author":"Lumb AB","year":"2021","edition":"9"},{"key":"bibr10-0310057X231198257","doi-asserted-by":"publisher","DOI":"10.1177\/0310057X211070292"},{"key":"bibr11-0310057X231198257","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2019.10.007"},{"key":"bibr12-0310057X231198257","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00037014"},{"key":"bibr13-0310057X231198257","first-page":"88","volume-title":"Nunn and Lumb\u2019s applied respiratory physiology","author":"Lumb AB","year":"2021","edition":"9"},{"key":"bibr14-0310057X231198257","doi-asserted-by":"publisher","DOI":"10.1177\/0310057X211060846"},{"key":"bibr15-0310057X231198257","unstructured":"Australian Government National Health and Medical Research Council. 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