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Comparison of Transnasal Humidified Rapid-Insufflation Ventilatory Exchange and Facemasks in Preoxygenation: A Systematic Review and Meta-Analysis

BACKGROUND: Transnasal Humidified Rapid-Insufflation Ventilatory Exchange (THRIVE) has received increasing attention and application as an effective noninvasive mode of ventilation in the treatment of clinical anesthesia and critically ill patients. The conclusions reached in clinical studies of THR...

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Autores principales: Li, Yongkai, Yang, Jianzhong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9300319/
https://www.ncbi.nlm.nih.gov/pubmed/35872871
http://dx.doi.org/10.1155/2022/9858820
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author Li, Yongkai
Yang, Jianzhong
author_facet Li, Yongkai
Yang, Jianzhong
author_sort Li, Yongkai
collection PubMed
description BACKGROUND: Transnasal Humidified Rapid-Insufflation Ventilatory Exchange (THRIVE) has received increasing attention and application as an effective noninvasive mode of ventilation in the treatment of clinical anesthesia and critically ill patients. The conclusions reached in clinical studies of THRIVE and facemask oxygenation are still controversial, and the main objective of this systematic review is to determine the advantages of THRIVE over facemask oxygenation in intensive care units, respiratory medicine, and perioperative preoxygenation. METHODS: PubMed, Embase, Web of Science, and Cochrane Library have search restrictions. The search library was full of English language articles from the first publication to 15 July 2021. Eligible randomized controlled study designs were included. 245 records were screened, and 5 studies met the inclusion criteria, enrolling a total of 235 patients. RESULTS: Studying the THRIVE group compared to the facemask group, three studies analyzing intubation time showed that there is no difference in the effect of THRIVE and facemasks (MD -1.22, 95% CI -7.23 to 4.78, and P = 0.69 > 0.05). Three studies analyzing apnea showed that there was no difference between the two groups (SMD 1, 95% CI -0.76 to 2.76, and P = 0.27 > 0.05). Three studies analyzing PaO(2) after preoxygenation showed that THRIVE is more effective than facemasks (MD 72.58, 95% CI 31.25 to 113.90, Z = 3.44, and P < 0.001). Two studies analyzing oxygen saturation SpO(2) after successful intubation showed that there was no difference in the effectiveness (MD 0.09, 95% CI -1.03 to 1.22, and P = 0.87 > 0.05). Two studies analyzing PCO(2) after complete paralysis or intubation preoxygenation showed that there was no difference between the two groups (MD 2.76, 95% CI -1.74 to 7.26, and P = 0.23 > 0.05). CONCLUSIONS: THRIVE does not have a greater advantage over a facemask in improving apnea time, oxygenation time, PCO(2), and SpO(2), but it has an advantage in improving arterial partial pressure of oxygen (PaO(2)) after preoxygenation, which can improve PaO(2) well. This trial is registered with the protocol registration number CRD42021268143.
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spelling pubmed-93003192022-07-21 Comparison of Transnasal Humidified Rapid-Insufflation Ventilatory Exchange and Facemasks in Preoxygenation: A Systematic Review and Meta-Analysis Li, Yongkai Yang, Jianzhong Biomed Res Int Review Article BACKGROUND: Transnasal Humidified Rapid-Insufflation Ventilatory Exchange (THRIVE) has received increasing attention and application as an effective noninvasive mode of ventilation in the treatment of clinical anesthesia and critically ill patients. The conclusions reached in clinical studies of THRIVE and facemask oxygenation are still controversial, and the main objective of this systematic review is to determine the advantages of THRIVE over facemask oxygenation in intensive care units, respiratory medicine, and perioperative preoxygenation. METHODS: PubMed, Embase, Web of Science, and Cochrane Library have search restrictions. The search library was full of English language articles from the first publication to 15 July 2021. Eligible randomized controlled study designs were included. 245 records were screened, and 5 studies met the inclusion criteria, enrolling a total of 235 patients. RESULTS: Studying the THRIVE group compared to the facemask group, three studies analyzing intubation time showed that there is no difference in the effect of THRIVE and facemasks (MD -1.22, 95% CI -7.23 to 4.78, and P = 0.69 > 0.05). Three studies analyzing apnea showed that there was no difference between the two groups (SMD 1, 95% CI -0.76 to 2.76, and P = 0.27 > 0.05). Three studies analyzing PaO(2) after preoxygenation showed that THRIVE is more effective than facemasks (MD 72.58, 95% CI 31.25 to 113.90, Z = 3.44, and P < 0.001). Two studies analyzing oxygen saturation SpO(2) after successful intubation showed that there was no difference in the effectiveness (MD 0.09, 95% CI -1.03 to 1.22, and P = 0.87 > 0.05). Two studies analyzing PCO(2) after complete paralysis or intubation preoxygenation showed that there was no difference between the two groups (MD 2.76, 95% CI -1.74 to 7.26, and P = 0.23 > 0.05). CONCLUSIONS: THRIVE does not have a greater advantage over a facemask in improving apnea time, oxygenation time, PCO(2), and SpO(2), but it has an advantage in improving arterial partial pressure of oxygen (PaO(2)) after preoxygenation, which can improve PaO(2) well. This trial is registered with the protocol registration number CRD42021268143. Hindawi 2022-07-13 /pmc/articles/PMC9300319/ /pubmed/35872871 http://dx.doi.org/10.1155/2022/9858820 Text en Copyright © 2022 Yongkai Li and Jianzhong Yang. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Li, Yongkai
Yang, Jianzhong
Comparison of Transnasal Humidified Rapid-Insufflation Ventilatory Exchange and Facemasks in Preoxygenation: A Systematic Review and Meta-Analysis
title Comparison of Transnasal Humidified Rapid-Insufflation Ventilatory Exchange and Facemasks in Preoxygenation: A Systematic Review and Meta-Analysis
title_full Comparison of Transnasal Humidified Rapid-Insufflation Ventilatory Exchange and Facemasks in Preoxygenation: A Systematic Review and Meta-Analysis
title_fullStr Comparison of Transnasal Humidified Rapid-Insufflation Ventilatory Exchange and Facemasks in Preoxygenation: A Systematic Review and Meta-Analysis
title_full_unstemmed Comparison of Transnasal Humidified Rapid-Insufflation Ventilatory Exchange and Facemasks in Preoxygenation: A Systematic Review and Meta-Analysis
title_short Comparison of Transnasal Humidified Rapid-Insufflation Ventilatory Exchange and Facemasks in Preoxygenation: A Systematic Review and Meta-Analysis
title_sort comparison of transnasal humidified rapid-insufflation ventilatory exchange and facemasks in preoxygenation: a systematic review and meta-analysis
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9300319/
https://www.ncbi.nlm.nih.gov/pubmed/35872871
http://dx.doi.org/10.1155/2022/9858820
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