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Transnasal Humidified Rapid Insufflation Ventilatory Exchange in children requiring emergent intubation (Kids

Shane George1,2,3,4,5, Susan Humphreys3, Tara Williams3

  • 1Children's Critical Care Service, Gold Coast University Hospital, Southport, Queensland, Australia.

BMJ Open
|February 22, 2019
PubMed

Insights

Transnasal Humidified Rapid Insufflation Ventilatory Exchange (THRIVE) may reduce adverse events during pediatric emergency intubations. This trial investigates THRIVE

Area of Science:

  • Pediatric Emergency Medicine
  • Critical Care
  • Respiratory Physiology

Background:

  • Emergency intubation in children is high-risk, with frequent adverse events like hypoxemia.
  • Current preoxygenation methods aim to maximize oxygen reserves but may be insufficient.
  • Transnasal Humidified Rapid Insufflation Ventilatory Exchange (THRIVE) has shown promise in elective settings.

Purpose of the Study:

  • To test if THRIVE reduces adverse and hypoxemic events during emergency pediatric intubations.
  • To evaluate the cost-effectiveness of THRIVE compared to standard care in this population.

Main Methods:

  • Multicenter randomized controlled trial (Kids THRIVE trial) in emergency departments and PICUs.
  • 960 children (0-16 years) requiring emergency intubation randomized 1:1 to THRIVE or control.
  • Primary outcomes: hypoxemic events (SpO2 <90%) and first-attempt intubation success without hypoxemia.

Main Results:

  • Data analysis is ongoing; results will be published upon completion.
  • The trial aims to provide definitive evidence on THRIVE's efficacy and safety.

Conclusions:

  • The study is expected to determine if THRIVE offers a significant benefit over standard care.
  • Findings will inform clinical practice guidelines for emergency airway management in children.
Abstract

Keywords:
airway managementapnoeic oxygenationintubationnasal high-flowpaediatricstransnasal humidified rapid insufflation ventilatory exchange

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