ArticleBMC anesthesiology2025
Severe intestinal distension following HFNC-assisted awake intubation with conversion to open Nissen fundoplication: a case report.
Article in BMC anesthesiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- High-Flow Nasal Oxygen in Contemporary Airway Management: Enhancing Physiological Safety in Anaesthesia-A Narrative Review.Healthcare (Basel, Switzerland) · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHigh-flow nasal cannula (HFNC) oxygen therapy is a commonly used respiratory support method delivering heated, humidified air at high flow rates with a positive end-expiratory pressure (PEEP) effect. HFNC improves oxygenation and facilitates awake fiberoptic intubation in the management of difficult airways. However, concerns about HFNC-induced gastric insufflation and intestinal distension have emerged, particularly in patients with lower esophageal sphincter dysfunction or hiatal hernia. We report a case of severe intestinal distension following HFNC-assisted awake fiberoptic intubation in a patient with a hiatal hernia scheduled for laparoscopic Nissen fundoplication. CASE PRESENTATION: A 50-year-old male patient was scheduled for a Nissen fundoplication procedure. Following preoperative airway examination, it was decided to proceed with awake intubation. HFNC was used as recommended in the guidelines to improve oxygenation. The patient was intubated with minimal sedation and airway topicalization under 40 L/min flow using a fiberoptic bronchoscope. The procedure was uneventful and the patient was handed over to the surgical team. Surgery began laparoscopically. However, excessive intestinal distension did not allow the surgery to continue with an optimum image. Aspirations with an orogastric tube and rectal tube could not improve the image and the patient had to undergo open surgery. The 5-hour open surgical procedure was completed without complications. Postoperative direct abdominal radiography showed dense intestinal air compared to the preoperative radiography.
conclusionsThis case underscores the potential risk of HFNC-induced intestinal distension, particularly in patients with predisposing factors such as hiatal hernia. Although HFNC is effective for airway management, careful patient selection and technique optimization are crucial. Further research is needed to clarify the impact of HFNC on gastrointestinal dynamics and to guide its safe application in at-risk populations.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.