SynthesisPloS one2025
High-flow nasal cannula for pre- and apneic oxygenation during rapid sequence induction intubation in emergency surgery: A systematic review and meta-analysis.
Synthesis in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- High-flow nasal oxygen versus face-mask ventilation for rapid sequence induction in non-elective surgical patients: a randomized controlled trial.BMC anesthesiology · 2026Trial
- Personalizing Peri-Intubation Oxygenation in Patients at Risk of Acute Hypoxemic Respiratory Failure: A Phenotype-Driven Narrative Review of High-Flow Nasal Oxygen and Non-Invasive Ventilation.Journal of personalized medicine · 2026Review
- High-flow nasal oxygen in the perioperative period: Enough evidence, or questions still unanswered?Indian journal of anaesthesia · 2026Article
- High-Flow Nasal Oxygen in Contemporary Airway Management: Enhancing Physiological Safety in Anaesthesia-A Narrative Review.Healthcare (Basel, Switzerland) · 2026Review
- Effectiveness of Apneic Oxygenation During Induction of General Anesthesia in Children Undergoing Adenotonsillectomy: A Prospective Randomized Controlled Study.Anesthesiology and pain medicine · 2026Article
- Ten tips for a safe approach in airway management.Journal of anesthesia, analgesia and critical care · 2026Review
- Preoxygenation When Standard Approaches Fail: Phenotype-Based Strategies for High-Risk Emergent Intubations.Journal of clinical medicine · 2026Review
- Review
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRapid sequence induction intubation (RSII) is commonly used in emergency surgeries for patients at high risk of aspiration. However, these patients are more susceptible to hypoxemia during the RSII process. High-flow nasal cannula (HFNC) oxygen therapy has emerged as a potential alternative to traditional face mask (FM) ventilation pre- and apneic oxygenation. This meta-analysis aimed to evaluate the efficacy of HFNC compared to FM during RSII in emergency surgeries.
methodsWe conducted a comprehensive literature search across PubMed-MEDLINE, EMBASE-OVID, Scopus, and Web of Science databases up to July 20, 2024. Randomized controlled trials comparing HFNC with FM during RSII for emergency surgery patients were included. The primary outcomes were post-intubation arterial partial pressures of oxygen (PaO2) and carbon dioxide (PaCO2). Secondary outcomes included post-intubation end-tidal carbon dioxide concentration (EtCO2), incidence of desaturation, apnea time, lowest peripheral oxygen saturation (Lowest SpO2), and occurrence of regurgitant aspiration. We used the GRADE approach to assess the certainty of evidence and the Cochrane Risk of Bias 2 (RoB 2) tool to evaluate risk of bias.
findingsThis meta-analysis encompassed six studies, involving a total of 703 patients. HFNC oxygen therapy demonstrated a significant increase in post-intubation arterial PaO2 compared to FM (mean difference = 63.02 mmHg, 95% CI: 8.99 to 117.05, p = 0.02), while no significant difference was observed in arterial PaCO2. Moreover, HFNC substantially prolonged apnea time (mean difference = 19.25 seconds, 95% CI: 1.69 to 36.82, p = 0.03). No statistically significant differences were found between HFNC and FM regarding EtCO2, incidence of desaturation, Lowest SpO2, or regurgitant aspiration.
conclusionThis systematic review and meta-analysis indicates that HFNC may be superior to FM for pre-oxygenation and apneic oxygenation during RSII in emergency surgeries, particularly in improving oxygenation. While these findings are promising, further high-quality research is necessary to establish definitive guidelines for HFNC use in this context.
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