{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T05:21:54Z","timestamp":1784697714320,"version":"3.55.0"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,4,5]],"date-time":"2023-04-05T00:00:00Z","timestamp":1680652800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>This study aimed to compare the use of the STRIVE Hi technique with 70 and 100% oxygen concentrations in children with 1st or 2nd degree laryngeal obstruction undergoing suspension laryngoscopic surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Children aged 1\u2009month to 6\u2009years scheduled for suspension laryngoscopic surgery with spontaneous respiration were randomly divided into the 70% oxygen concentration group (HFNO70% group) and the 100% oxygen concentration group (HFNO100% group). The data recorded for all the patients included age and sex, comorbidities, preoperative physiological status, methods of induction and maintenance of anesthesia, course of the disease and surgical options, and duration of operation. The primary endpoint was the lowest oxygen saturations during the surgery. The secondary endpoints included the partial pressure of oxygen PaO<jats:sub>2<\/jats:sub>, the arterial pressure of carbon dioxide PaCO<jats:sub>2<\/jats:sub>, the peak transcutaneous carbon dioxide PtcCO<jats:sub>2<\/jats:sub>, and the incidence of desaturation (defined as SpO<jats:sub>2<\/jats:sub>\u2009&amp;lt;\u200990%) or hypercarbia (PtcCO<jats:sub>2<\/jats:sub>\u2009&amp;gt;\u200965\u2009mmHg).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 80 children with 1st or 2nd degree laryngeal obstruction were included in the analysis. The median [IQR (range)] duration of spontaneous ventilation using STRIVE Hi was 52.5 [40\u201360 (30\u2013170)]min and 62.5 [45\u201381 (20\u2013200)]min in the HFNO 70% and HFNO 100% groups, respectively (<jats:italic>p<\/jats:italic>\u2009=\u20090.99); the lowest oxygen saturation recorded during the operation was 97.8\u2009\u00b1\u20092.1% and 96.8\u2009\u00b1\u20092.5%, respectively (<jats:italic>p<\/jats:italic>\u2009=\u20090.053); the mean PaO<jats:sub>2<\/jats:sub> at the end of surgery was 184.6\u2009\u00b1\u200956.3\u2009mmHg and 315.2\u2009\u00b1\u2009101.3\u2009mmHg, respectively (<jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.001); and the peak transcutaneous CO<jats:sub>2<\/jats:sub> was 58.0\u2009\u00b1\u200913.0\u2009mmHg and 60.4\u2009\u00b1\u200910.9\u2009mmHg, respectively (<jats:italic>p<\/jats:italic>\u2009=\u20090.373), despite a long operation time.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>STRIVE Hi had a positive effect on children undergoing tubeless laryngeal surgery with spontaneous ventilation, and for children with 1st or 2nd degree laryngeal obstruction, there was no significant difference in maintaining the intraoperative oxygenation between the 70 and 100% oxygen concentration groups. The 100% oxygen concentration group showed significant hyperoxia, which has been proven to be associated with multiple organ damage. Using a relatively lower oxygen concentration of 70% can effectively reduce the hazards associated with hyperoxia compared to 100% oxygen concentration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical trial registration<\/jats:title><jats:p>[<jats:ext-link>www.chictr.org.cn<\/jats:ext-link>], identifier [CHICTR2200064500].<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2023.1169345","type":"journal-article","created":{"date-parts":[[2023,4,5]],"date-time":"2023-04-05T05:02:35Z","timestamp":1680670955000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Comparison of the application of high-flow nasal oxygen with two different oxygen concentrations in infant and child laryngotracheal surgery"],"prefix":"10.3389","volume":"10","author":[{"given":"Jianxia","family":"Liu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Xiong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haisu","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Du","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xue","family":"Ru","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,4,5]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"942","DOI":"10.1111\/j.1460-9592.2007.02300.x","article-title":"Airway management and anesthesia in neonates, infants and children during endolaryngotracheal surgery","volume":"17","author":"Mausser","year":"2007","journal-title":"Paediatr Anaesth"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"110042","DOI":"10.1016\/j.ijporl.2020.110042","article-title":"Pediatric airway surgery under spontaneous respiration using high-flow nasal oxygen","volume":"134","author":"Ji","year":"2020","journal-title":"Int J Pediatr Otorhinolaryngol"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1046\/j.1460-9592.1998.00732.x","article-title":"A modified technique of tubeless anaesthesia for microlaryngoscopy and bronchoscopy in young children with stridor","volume":"8","author":"Thaung","year":"1998","journal-title":"Paediatr Anaesth"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"616","DOI":"10.1111\/pan.13151","article-title":"Nasal high-flow oxygen delivery in children with abnormal airways","volume":"27","author":"Humphreys","year":"2017","journal-title":"Paediatr Anaesth"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"444","DOI":"10.1093\/bja\/aew468","article-title":"SponTaneous respiration using IntraVEnous anaesthesia and hi-flow nasal oxygen (STRIVE hi) maintains oxygenation and airway patency during management of the obstructed airway: an observational study","volume":"118","author":"Booth","year":"2017","journal-title":"Br J Anaesth"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1206","DOI":"10.1111\/pan.12992","article-title":"High-flow nasal cannula therapy and apnea time in laryngeal surgery","volume":"26","author":"Riva","year":"2016","journal-title":"Paediatr Anaesth"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1111\/coa.13252","article-title":"Indications of transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) in laryngoscopy, a prospective study of 19 cases","volume":"44","author":"Maupeu","year":"2019","journal-title":"Clin Otolaryngol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"587","DOI":"10.1002\/lary.28776","article-title":"Utility of transnasal humidified rapid insufflation ventilatory exchange for microlaryngeal surgery","volume":"131","author":"Benninger","year":"2021","journal-title":"Laryngoscope"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1341","DOI":"10.1007\/s10877-021-00765-2","article-title":"The outcomes of using high oxygen concentration in pediatric patients","volume":"36","author":"Saracoglu","year":"2021","journal-title":"J Clin Monit Comput"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"232","DOI":"10.1093\/bja\/aew401","article-title":"Transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) in children: a randomized controlled trial","volume":"118","author":"Humphreys","year":"2017","journal-title":"Br J Anaesth"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1093\/bja\/aew432","article-title":"Transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) in children: a step forward in apnoeic oxygenation, paradigm-shift in ventilation, or both?","volume":"118","author":"Jagannathan","year":"2017","journal-title":"Br J Anaesth"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"610","DOI":"10.1093\/bja\/aex036","article-title":"Apnoeic oxygenation in adults under general anaesthesia using Transnasal humidified rapid-insufflation Ventilatory exchange (THRIVE) - a physiological study","volume":"118","author":"Gustafsson","year":"2017","journal-title":"Br J Anaesth"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"e439","DOI":"10.1542\/peds.2009-0434","article-title":"Preterm resuscitation with low oxygen causes less oxidative stress, inflammation, and chronic lung disease","volume":"124","author":"Vento","year":"2009","journal-title":"Pediatrics"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1016\/j.siny.2010.03.007","article-title":"Long term consequences of oxygen therapy in the neonatal period","volume":"15","author":"Jobe","year":"2010","journal-title":"Semin Fetal Neonatal Med"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"675293","DOI":"10.3389\/fmed.2021.675293","article-title":"Hyperoxemia is associated with mortality in critically ill children","volume":"8","author":"Pelletier","year":"2021","journal-title":"Front Med (Lausanne)"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1508","DOI":"10.1097\/CCM.0000000000000998","article-title":"Association between arterial hyperoxia and outcome in subsets of critical illness: a systematic review, meta-analysis, and meta-regression of cohort studies","volume":"43","author":"Helmerhorst","year":"2015","journal-title":"Crit Care Med"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"732039","DOI":"10.3389\/fmed.2021.732039","article-title":"Hyperoxia provokes time- and dose-dependent gut injury and endotoxemia and alters gut microbiome and transcriptome in mice","volume":"8","author":"Li","year":"2021","journal-title":"Front Med (Lausanne)"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"e0130771","DOI":"10.1371\/journal.pone.0130771","article-title":"Effect of acute hypercapnia on outcomes and predictive risk factors for complications among patients receiving bronchoscopic interventions under general anesthesia","volume":"10","author":"Cheng","year":"2015","journal-title":"PLoS One"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"779","DOI":"10.1038\/jp.2008.99","article-title":"Subcutaneous scalp emphysema, pneumo-orbitis and pneumocephalus in a neonate on high humidity high flow nasal cannula","volume":"28","author":"Jasin","year":"2008","journal-title":"J Perinatol"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"e939","DOI":"10.1542\/peds.2011-3767","article-title":"Serious air leak syndrome complicating high-flow nasal cannula therapy: a report of 3 cases","volume":"131","author":"Hegde","year":"2013","journal-title":"Pediatrics"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1080\/14767058.2019.1606193","article-title":"High-flow nasal cannula versus nasal continuous positive airway pressure for respiratory support in preterm infants: a meta-analysis of randomized controlled trials","volume":"34","author":"Hong","year":"2021","journal-title":"J Matern Fetal Neonatal Med"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"456","DOI":"10.1093\/icvts\/ivu171","article-title":"Comparative evaluation of high-flow nasal cannula and conventional oxygen therapy in pediatric cardiac surgical patients: a randomized controlled trial","volume":"19","author":"Testa","year":"2014","journal-title":"Interact Cardiovasc Thorac Surg"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2023.1169345\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,5]],"date-time":"2023-04-05T05:02:37Z","timestamp":1680670957000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2023.1169345\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,5]]},"references-count":22,"alternative-id":["10.3389\/fmed.2023.1169345"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2023.1169345","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,5]]},"article-number":"1169345"}}