PDF(Pubmed)
Abstract：
High-flow nasal oxygen (HFNO) therapy is extensively used in critical care units for spontaneously breathing patients. Trans-nasal humidified rapid insufflation ventilatory exchange (THRIVE) is a method of apnoeic oxygenation with continuous nasal delivery of warmed, humidified oxygen at high-flow rates up to 70L/min. THRIVE extends the apnoeic window before desaturation occurs so that tubeless anaesthesia is possible. The advent of THRIVE has had a monumental impact on anaesthetic practice, with a diverse range of clinical applications and it has been incorporated into difficult airway guidelines. THRIVE has many applications in otolaryngology and head and neck surgery. It is used as a pre-oxygenation tool during induction in both anticipated and unanticipated difficult airway scenarios and as a method of oxygenation for tubeless anaesthesia in elective laryngotracheal and hypopharyngeal surgeries and during emergence from anaesthesia. In this scoping review of the literature, we aim to provide an overview on the utility of THRIVE in otolaryngology, including the underlying physiologic principles, current indications and limitations, and its feasibility and safety in different surgical contexts and specific population groups.
摘要：
高流量鼻氧气（HFNO）治疗广泛用于重症监护病房，用于自主呼吸患者。经鼻加湿快速吹气换气（THRIVE）是一种呼吸暂停充氧的方法，持续鼻腔给药，加湿氧气在高流速达70L/min。THRIVE在去饱和发生之前延长了呼吸暂停窗口，因此可以进行无管麻醉。THRIVE的出现对麻醉实践产生了巨大的影响，具有多种临床应用，并已被纳入困难的气道指南。THRIVE在耳鼻咽喉科和头颈部手术中有许多应用。在预期和意外困难的气道情况下，它在诱导过程中用作预充氧工具，在选择性喉气管和下咽手术中以及在麻醉出现期间用作无管麻醉的充氧方法。在这篇范围界定的文献综述中，我们的目标是概述THRIVE在耳鼻喉科的实用性，包括基本的生理原理，当前的适应症和限制，及其在不同手术环境和特定人群中的可行性和安全性。
