Physiologic effects of Transnasal Humidified Rapid-Insufflation Ventilatory Exchange (THRIVE) versus facemask preoxygenation in obese patients undergoing bariatric surgery: A pilot observational electrical impedance tomography study
Authors' conclusion
In this exploratory observational study, THRIVE was associated with greater dorsal ventilation distribution and higher impedance-derived end-expiratory lung aeration in obese patients undergoing bariatric surgery.
Study context
- Population
- Adults (BMI ≥35 kg/m²) scheduled for elective laparoscopic sleeve gastrectomyanalysed
- Participants
- Sixty-five adults
- Exposure
- THRIVE vs facemask preoxygenation
- THRIVEn = 33
- Facemaskn = 32reference
- Outcome
- Regional ventilation distribution by predefined Regions of Interest (ROIs) and change in end-expiratory lung impedance (ΔEELI%)
Methodological detailselectrical impedance tomography
- Electrical impedance tomography
Main finding
As reported in the abstract
Dorsal ventilation (ROI4) at T2 (pneumoperitoneum): THRIVE vs facemask, p < 0.05
32.4 ± 13.7% vs 18.1 ± 8.7%
Dorsal ventilation (ROI4) at T3 (end of surgery, awake): THRIVE vs facemask, p < 0.05
30.6 ± 11.7% vs 20 ± 8.9%
ΔEELI% at T2: THRIVE vs facemask, p < 0.05
97.5 [395.7] vs 33 [285.4]
ΔEELI% at T3: THRIVE vs facemask, p < 0.05
109 [479] vs −58.5 [346.2]
Observational data: associations, not effects.
Secondary outcomes
PEEPtot · T2
P = 0.02
PaO₂ · T2
P < 0.05
PaCO₂ · T3
P < 0.05
Respiratory mechanics and gas exchange overall
- Largely comparable between groups
Original publication
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