Transnasal Humidified Rapid Insufflation Ventilatory Exchange Augments Oxygenation in Children With Juvenile Onset Recurrent Respiratory Papillomatosis During Surgery
A Prospective Randomized Crossover Controlled Trial
Submitted December 2023 by Dr Chris Brasher
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Children undergoing suspension laryngoscopy for papillomatosis surgery were randomised to either THRIVE or room air during apnoea. All patients were paralysed and intubated/ventilated periodically. No laser was used. Apnoea time to desaturation on air was 3.8 minutes, on THRIVE it 8.9 minutes. The increase in transcutaneous CO2 measurements was also significantly lower. Of note, the study design was to intubate at eight minutes of apnoea, and 26 of 28 patients in the THRIVE group were still saturating at 100% at eight minutes.
This study is a good demonstration of the difference between THRIVE and room air in paralysed apnoeic paediatric patients. THRIVE will predictably provide over 8 minutes of oxygenation in paediatric patients.