Related Experiment Video
Updated: May 8, 2026

A Novel Rescue Technique for Difficult Intubation and Difficult Ventilation
Published on: January 17, 2011
Is a nasopharyngeal tube effective as interface to provide bi-level noninvasive ventilation?
Eneritz Velasco Arnaiz1, Francisco José Cambra Lasaosa, Lluïsa Hernández Platero
1Pediatric Intensive Care Unit, Hospital Universitario Sant Joan de Déu, Barcelona, Spain.
Background:
The nasopharyngeal tube (NT) is a potential interface for noninvasive ventilation (NIV) available in all health care centers. The aim of the study was to describe our experience in the use of the NT for bi-level NIV in infants and its effectiveness.
Methods:
Prospective observational study from January 2007 to December 2010, including all patients ≤ 6 months old admitted to the pediatric ICU (PICU) and treated with NIV with two levels of pressure using the NT. Clinical data collected before starting NIV, and at 2, 8, 12 and 24 h, were analyzed following NIV initiation: first-line or initial NIV (i-NIV), elective postextubation NIV (e-NIV), and rescue postextubation NIV (r-NIV). The need for intubation was considered to be NIV failure.
Results:
One hundred fifty-one episodes of NIV were included in the study, with 65% of patients having bronchiolitis. e-NIV was most frequently used (48%) (i-NIV 44%, r-NIV 8%), and the failure rate, 27% in total, was highest in the i-NIV group (37%) (e-NIV 18%, r-NIV 25%). Case patients with successful outcomes had shorter PICU stays (8.5 vs. 13 d, P = .001) and hospital stays (17 vs. 23 d, P = .03) stays. The NT needed to be changed for another interface in only 5 case patients, few complications (4 of 151 patients) were observed, and mortality (2 of 151 patients) was unrelated to NIV.
Conclusions:
Use of the NT showed 73% effectiveness, with few complications. The effectiveness was higher in e-NIV than i-NIV.
Related Concept Videos
Mechanical Ventilation III: Noninvasive Ventilation
Noninvasive Positive-Pressure Ventilation (NIPPV)
Endotracheal Intubation I: Procedure
The ET tube comprises various components, including a standard adaptor to attach a bag-valve-mask (BVM) or ventilator, a cuff, a pilot balloon, and radiopaque markings along its length to measure the insertion distance. The tube sizes...
Mechanical Ventilation II: Invasive Ventilation
Negative-Pressure Ventilators
Negative-pressure ventilators create a vacuum around the chest or body to draw air into the lungs, simulating breathing. This method does not require an...
Suctioning the Nasopharyngeal Airway
Equipment Required
Oxygen Delivering System II: Venturi Mask and Transtracheal Oxygen
Venturi Mask
The Venturi mask, named after the Venturi effect, is designed to deliver precise oxygen concentrations. It consists of a large tube with an oxygen inlet that narrows down, causing a pressure drop that pulls air in through adjustable side ports. The mask is a lightweight,...
Enteral Nutrition I: Orogastric and Nasogastric Feeding
Orogastric (OG) and nasogastric (NG) feeding are two standard methods used for enteral nutrition. Enteral nutrition is often preferred over...