{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T20:05:44Z","timestamp":1787169944924,"version":"build-2736575974"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Aims:<\/jats:title>\n                    <jats:p>Robotic flexible ureteroscopy often requires intermittent apnoeic periods to minimise kidney movement and improve surgical conditions. This study evaluated the effectiveness of high-flow oxygenation (HFO) in maintaining oxygenation and preventing desaturation during retrograde flexible ureteroscopy (RFU).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This retrospective cohort study included 62 male patients undergoing robotic RFU: 28 received HFO and 34 served as controls. The HFO group underwent repeated 5-minute apnoeic periods with 100% oxygen delivered at up to 80 L\/min. Vital parameters were recorded before and after each apnoeic period. In the control group, the tidal volume was reduced to 250 mL with a respiratory rate of 20 cycles per minute during the robotic phase, and these settings were maintained throughout. Wilcoxon rank-sum test, T-tests, and Fisher\u2019s exact test were used to compare the groups. Durbin\u2013Conover test was used for pairwise comparisons.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Compared to the HFO group, overall, the control group had slightly higher median end-tidal carbon dioxide (EtCO2) levels (43.3 vs 41.6,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.021), heart rate (71.6 vs 65.1,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.001), mean arterial pressure (83 vs 70.6,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), and temperature (36.5 vs 35.6,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). No desaturation events or haemodynamic instability occurred in the HFO group. ORI and PI remained stable, and no postoperative complications were reported.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>HFO during robotic ureteroscopy appears effective in maintaining oxygenation and haemodynamic stability while providing a still surgical field. These findings support its integration into clinical practice for procedures requiring controlled apnoea.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ija.ija_897_25","type":"journal-article","created":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T17:00:27Z","timestamp":1771606827000},"page":"342-348","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["High-flow oxygen delivery system and oxygen reserve index-guided apnoeic oxygenation versus low-tidal-volume ventilation during robotic flexible ureteroscopy: A retrospective cohort study"],"prefix":"10.4103","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1186-0933","authenticated-orcid":false,"given":"Ayten","family":"Saracoglu","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Florida University, UF Health, Jacksonville, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2238-1305","authenticated-orcid":false,"given":"Mariah","family":"Arif","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, ICU, and Perioperative Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6765-8489","authenticated-orcid":false,"given":"Morshed","family":"Salah","sequence":"additional","affiliation":[{"name":"Department of Urology, Hazm Mebaireek General Hospital, Hamad Medical Corporation, Doha, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1025-4026","authenticated-orcid":false,"given":"Ruslan","family":"Abdullayev","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Reanimation, Marmara University College of Medicine, Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8190-6730","authenticated-orcid":false,"given":"Bela","family":"Tallai","sequence":"additional","affiliation":[{"name":"Department of Urology, Hazm Mebaireek General Hospital, Hamad Medical Corporation, Doha, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haitham","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, ICU and Perioperative Medicine, Aisha Bint Hamad Al Attiyah Hospital, Hamad Medical Corporation, Doha, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-7290-0999","authenticated-orcid":false,"given":"Ahmed M. I.","family":"Ibrahim","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, ICU and Perioperative Medicine, Aisha Bint Hamad Al Attiyah Hospital, Hamad Medical Corporation, Doha, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6242-5667","authenticated-orcid":false,"given":"Abdulla","family":"Al Ansari","sequence":"additional","affiliation":[{"name":"Department of Urology, Hazm Mebaireek General Hospital, Hamad Medical Corporation, Doha, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9470-7418","authenticated-orcid":false,"given":"Kemal T.","family":"Saracoglu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Florida University, UF Health, Jacksonville, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,2,21]]},"reference":[{"key":"R1-20260417","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1007\/s11701-024-01858-1","article-title":"Optimizing outcome reporting after robotic flexible ureteroscopy for management of renal calculi: Introducing the concept of tetrafecta","volume":"18","author":"Salah","year":"2024","journal-title":"J Robot Surg"},{"key":"R2-20260417","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1053\/j.ackd.2015.03.005","article-title":"Minimally invasive surgical treatment for kidney stone disease","volume":"22","author":"Rodr\u00edguez","year":"2015","journal-title":"Adv Chronic Kidney Dis"},{"key":"R3-20260417","doi-asserted-by":"crossref","first-page":"589","DOI":"10.4111\/icu.20220272","article-title":"The era of robotic flexible ureteroscopic management of urinary calculi and the domain of \u2018surgeons\u2019 in the endoscopic surgical procedures","volume":"63","author":"Choo","year":"2022","journal-title":"Investig Clin Urol"},{"key":"R4-20260417","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1186\/s12894-019-0491-3","article-title":"Reducing kidney motion: Optimizing anesthesia and combining respiratory support for retrograde intrarenal surgery: A pilot study","volume":"19","author":"Gadzhiev","year":"2019","journal-title":"BMC Urol"},{"key":"R5-20260417","first-page":"415","article-title":"Ergonomics and surgeon comfort during flexible ureteroscopy","volume":"13","author":"Alnadhari","year":"2021","journal-title":"Res Rep Urol"},{"key":"R6-20260417","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1186\/s12871-020-01073-z","article-title":"High-flow nasal cannula improves clinical efficacy of airway management in patients undergoing awake craniotomy","volume":"20","author":"Yi","year":"2020","journal-title":"BMC Anesthesiol"},{"key":"R7-20260417","first-page":"081","article-title":"Apneic oxygenation and high flow","volume":"5","author":"Saracoglu","year":"2018","journal-title":"Int J Anesthetic Anesthesiol"},{"key":"R8-20260417","doi-asserted-by":"crossref","first-page":"37","DOI":"10.4314\/mmj.v34i1.7","article-title":"Factors affecting the failure of high flow nasal cannula oxygen therapy in \u0131ntensive care follow-up of COVID-19 severe respiratory failure","volume":"34","author":"Ciyiltepe","year":"2022","journal-title":"Malawi Med J"},{"key":"R9-20260417","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1007\/s00240-017-1030-x","article-title":"Flexible ureteroscopy: Technique, tips and tricks","volume":"46","author":"Doizi","year":"2018","journal-title":"Urolithiasis"},{"key":"R10-20260417","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1186\/s12877-023-04125-4","article-title":"Effects of permissive hypercapnia on intraoperative cerebral oxygenation and early postoperative cognitive function in older patients with non-acute fragile brain function undergoing laparoscopic colorectal surgery: Protocol study","volume":"23","author":"Li","year":"2023","journal-title":"BMC Geriatr"},{"key":"R11-20260417","doi-asserted-by":"crossref","first-page":"1793","DOI":"10.3174\/ajnr.A8714","article-title":"The effect of diagnostic hypercapnic cerebrovascular reactivity imaging on vital signs and acute and follow-up ischemic adverse events in patients with flow-limiting intracranial arterial stenosis","volume":"46","author":"Leguizamon","year":"2025","journal-title":"AJNR Am J Neuroradiol"},{"key":"R12-20260417","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1111\/anae.12923","article-title":"Transnasal humidified rapid-insufflation ventilatory exchange (THRIVE): A physiological method of increasing apnoea time in patients with difficult airways","volume":"70","author":"Patel","year":"2015","journal-title":"Anaesthesia"},{"key":"R13-20260417","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1016\/j.bja.2017.12.017","article-title":"Transnasal humidified rapid insufflation ventilatory exchange for oxygenation of children during apnoea: A prospective randomised controlled trial","volume":"120","author":"Riva","year":"2018","journal-title":"Br J Anaesth"},{"key":"R14-20260417","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1111\/anae.15335","article-title":"Evaluating the ventilatory effect of transnasal humidified rapid insufflation ventilatory exchange in apnoeic small children with two different oxygen flow rates: A randomised controlled trial","volume":"76","author":"Riva","year":"2021","journal-title":"Anaesthesia"},{"key":"R15-20260417","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1111\/anae.14565","article-title":"Uses and mechanisms of apnoeic oxygenation: A narrative review","volume":"74","author":"Lyons","year":"2019","journal-title":"Anaesthesia"},{"key":"R16-20260417","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1093\/bja\/aen139","article-title":"Major complications during anaesthesia for elective laryngeal surgery in the UK: A national survey of the use of high-pressure source ventilation","volume":"101","author":"Cook","year":"2008","journal-title":"Br J Anaesth"},{"key":"R17-20260417","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1016\/j.urology.2016.06.016","article-title":"The use of apnea during ureteroscopy","volume":"97","author":"Emiliani","year":"2016","journal-title":"Urology"},{"key":"R18-20260417","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.rmr.2022.11.004","article-title":"Place de l\u2019oxyg\u00e9noth\u00e9rapie nasale \u00e0 haut d\u00e9bit en p\u00e9riop\u00e9ratoire [The perioperative role of high-flow cannula oxygen (HFNO)]","volume":"40","author":"Genty","year":"2023","journal-title":"Rev Mal Respir"},{"key":"R19-20260417","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1186\/s12871-024-02755-8","article-title":"Oxygen reserve index vs. peripheral oxygen saturation for the prediction of hypoxemia in morbidly obese patients: A prospective observational study","volume":"24","author":"Sara\u00e7o\u011flu","year":"2024","journal-title":"BMC Anesthesiol"},{"key":"R20-20260417","doi-asserted-by":"crossref","first-page":"97","DOI":"10.5152\/TJAR.2023.21435","article-title":"A perfusion index-based evaluation and comparison of peripheral perfusion in sevoflurane and isoflurane anaesthesia: A prospective randomised controlled trial","volume":"51","author":"Ajayan","year":"2023","journal-title":"Turk J Anaesthesiol Reanim"},{"key":"R21-20260417","first-page":"101276","article-title":"The effective use of high flow oxygenation delivery system during robotic assisted flexible ureteroscopy: A case report","volume":"51","author":"Saracoglu","year":"2023","journal-title":"Trends Anesth Crit Care"}],"container-title":["Indian Journal of Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ija.ija_897_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:15:20Z","timestamp":1787166920000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ija.ija_897_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2]]},"references-count":21,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/ija.ija_897_25","relation":{},"ISSN":["0019-5049","0976-2817"],"issn-type":[{"value":"0019-5049","type":"print"},{"value":"0976-2817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2]]},"assertion":[{"value":"2025-07-11","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-21","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}