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A propensity score-adjusted analysis of efficacy of high-flow nasal oxygen during awake tracheal intubation

 Hye Jin Kim  ;  Min-Soo Kim  ;  So Yeon Kim  ;  In Kyung Min  ;  Wyun Kon Park  ;  Sei Han Song  ;  Dongkwan Shin  ;  Hyun Joo Kim 
 SCIENTIFIC REPORTS, Vol.12(1) : 11306, 2022-07 
Journal Title
Issue Date
Humans ; Intubation, Intratracheal / adverse effects ; Intubation, Intratracheal / methods ; Oxygen* ; Propensity Score ; Retrospective Studies ; Trachea ; Wakefulness*
Oxygen supplementation is crucial for awake tracheal intubation (ATI) using a flexible bronchoscope in patients with an anticipated difficult airway. However, the modality of optimal oxygen delivery remains unclear. This retrospective study compared high-flow nasal oxygen (HFNO) and conventional low-flow oxygen supply during ATI. We applied inverse probability of treatment weighting (IPTW) to account for biases due to clinical characteristic differences between the groups. The primary endpoint was the lowest oxygen saturation during ATI. The secondary endpoints were incidence of desaturation, multiple attempts, failure rate, and procedural duration. After IPTW adjustment, the lowest oxygen saturation in the HFNO group during ATI was significantly higher than that in the conventional oxygenation group (99.3 ± 0.2 vs. 97.5 ± 0.5, P < 0.001). Moreover, the HFNO group had fewer cases with multiple attempts than the conventional oxygenation group (3% vs. 16%, P = 0.007). There were no significant differences between the two groups in the incidence of desaturation, failure and procedural duration. Our findings suggest that HFNO was associated with improved lowest oxygen saturation and a lower rate of multiple attempts during ATI. Therefore, we recommend using HFNO for safer oxygen delivery and improved quality of procedure during ATI.
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Min Soo(김민수) ORCID logo https://orcid.org/0000-0001-8760-4568
Kim, So Yeon(김소연) ORCID logo https://orcid.org/0000-0001-5352-157X
Kim, Hyun Joo(김현주) ORCID logo https://orcid.org/0000-0003-1963-8955
Kim, Hye Jin(김혜진) ORCID logo https://orcid.org/0000-0003-3452-477X
Park, Wyun Kon(박윤곤)
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