Paediatric anaesthesia & critical care
High-flow nasal oxygen for children's airway surgery to reduce hypoxaemic events: a randomised controlled trial
Authors' conclusion
Nasal high-flow oxygen during tubeless upper airway surgery did not reduce the proportion of interruptions of the procedures for rescue oxygenation compared with standard care.
Study context
- Population
- Children aged 0–16 years requiring tubeless upper airway surgery, 5 tertiary hospitals in Australiaprocedures in 483 children (ITT)
- Participants
- 528 children
- Comparison
- Nasal high-flow oxygen vs standard oxygen therapy
- High-flow oxygenn = 267
- Standard caren = 261reference
- Primary endpoint
- Successful anaesthesia without interruption of surgery for rescue oxygenation (positive pressure ventilation by bag mask, ETT or LMA)
Methodological detailsmulticentre, open-label (oxygen therapy not masked; investigators blinded until data lock), stratified by site and age
- Multicentre
- Open-label (oxygen therapy not masked; investigators blinded until data lock)
- Stratified by site and age
Primary result
As reported in the abstract
Successful anaesthesia without interruption of surgery for rescue oxygenation (higher = better)
Secondary outcomes
| Outcome | High-flow oxygen | Standard care | RR (95% CI) | |
|---|---|---|---|---|
| Procedures with a hypoxaemic event (SpO2 <90%) | 19% | 22% | 0.86 (0.58–1.24) | |
| 0.512Relative risk (log scale) |
Other prespecified secondary outcomes
- None showed a significant difference between groups
Safety
Adverse events (epistaxis, laryngospasm, bronchospasm, hypoxaemia, bradycardia, cardiac arrest, hypotension, death)
- Similar in both study groups
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
High-flow nasal oxygen for children's airway surgery to reduce hypoxaemic events: a randomised controlled trial. Lancet Respir Med. Published 21 May 2024. doi:10.
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