Related Experiment Video
Updated: May 28, 2025
A Novel Rescue Technique for Difficult Intubation and Difficult Ventilation
Published on: January 17, 2011
Transnasal humidified rapid insufflation ventilatory exchange (THRIVE): A game changer in apnoeic anaesthesia for
Minal Harde1, Manish Patil1, Anjana Sahu1
1Department of Anaesthesiology, Topiwala National Medical College and B.Y.L. Nair Hospital, Mumbai, Maharashtra, India.
Background And Aims:
Transnasal humidified rapid insufflation ventilatory exchange (THRIVE) is a valuable adjunct during apnoea. Conventional techniques of apnoeic anaesthesia have limitations. THRIVE helps to maintain oxygenation during the apnoeic periods in tubeless airway surgeries. We aimed to evaluate tubeless apnoeic anaesthesia in shared airways using THRIVE to determine safe apnoea time.
Methods:
Two years of retrospective data were collected at a tertiary care centre, which included 60 patients in whom THRIVE was used for apnoeic anaesthesia. We appraised tubeless apnoeic anaesthesia in shared airways using THRIVE to determine safe apnoea time. Data on oxygenation, haemodynamic parameters, ventilation and the perioperative course were also collected. The data were analysed using GNU PSPP 1.0.1 software.
Results:
The patients' mean age was 48.53 [standard deviation (SD):16.62] years. Microlaryngoscopy [24 (40%)], rigid bronchoscopy [12 (20%)], tracheal dilatation [12 (20%)] and foreign body removal [8 (13.3%)] were the common procedures. The mean apnoea time was 14.5 (SD: 2.05) min. Patients maintained normal haemodynamic parameters, with a mean oxygen saturation of 98% during apnoea. The highest mean end-tidal carbon dioxide at the end of apnoea was 55 mmHg, which normalised after 1-2 min of ventilation. Intermittent ventilation was done in eight patients as the apnoea time exceeded 20 min. Emergence and recovery were smooth, and none of the patients developed any complications throughout the procedure.
Conclusion:
THRIVE can be effectively and safely used for tubeless apnoeic anaesthesia, with an uninterrupted apnoea time of approximately 15 min without complications.
More Related Videos
05:43Topical Airway Anesthesia for Awake-endoscopic Intubation Using the Spray-as-you-go Technique with High Oxygen Flow
Published on: January 13, 2017
05:39Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia
Published on: May 26, 2023
Related Concept Videos
01:23Mechanical Ventilation III: Noninvasive Ventilation
Noninvasive Positive-Pressure Ventilation...
01:16Oxygen 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,...
01:30Acute Respiratory Failure-III
01:21Acute Respiratory Failure-II
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
01:29Suctioning the Nasopharyngeal Airway
Equipment Required
01:23Oxygen Delivering System III: Tracheostomy and T-piece
Tracheostomy
A tracheostomy is a surgically created opening (stoma) in the anterior part of the trachea. It is used to establish a patient airway, bypass an upper airway obstruction, simplify the removal of secretions, permit long-term...