Related Experiment Video
Updated: Aug 14, 2026

Preoxygenation Techniques for Tracheal Intubation in Critically Ill Adults Utilizing Oxygen Mask and Noninvasive Ventilation
Published on: December 5, 2025
Low-flow transtracheal rescue insufflation of oxygen after profound desaturation
Ian H Black1, Scott A Janus, Kurt W Grathwohl
1Walter Reed Army Institute of Research, Silver Spring, Maryland, USA. ian.h.black@us.army.mil
Background:
The objective of this study was to determine whether low-flow transtracheal insufflation of oxygen (TRIO) could rescue an animal from profound desaturation. This temporizing maneuver could be useful during cannot-intubate or -ventilate scenarios by resolving hypoxia without the morbidity associated with more invasive procedures.
Methods:
Seven swine for a total of 12 runs were studied. Animals were pharmacologically anesthetized, paralyzed, and mechanically ventilated with room air. After disconnection from the ventilator and desaturation to an Spo2 < 50%, low-flow TRIO (2 L/min) was administered for 1 hour.
Results:
All animals survived and Spo2 increased to greater than 90% in 23 seconds on average. Pao2 (mean, 183 mm Hg) remained elevated throughout the study. Hemodynamic stability was maintained for at least 15 minutes.
Conclusion:
Low-flow TRIO rescued animals from profound hypoxia and maintained oxygenation for at least 1 hour. Low-flow TRIO did not prevent hypercarbia with its subsequent sympathetic activation.
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