Related Experiment Video
Updated: Mar 13, 2026
Preoxygenation Techniques for Tracheal Intubation in Critically Ill Adults Utilizing Oxygen Mask and Noninvasive Ventilation
Published on: December 5, 2025
The effect of high-flow nasal cannula oxygen therapy on preventing hypoxemia during deep sedation extubation after
Yi-Kai Wang1,2, Xiang Li1,3, Shi-You Wei3
1The First Affiliated Hospital of Anhui Medical University, Hefei, 230032, China.
Background:
High-flow nasal cannula (HFNC) oxygen therapy has shown potential benefits in improving oxygenation in perioperative settings. However, its role in preventing early postoperative hypoxemia after extubation under deep sedation during laparoscopic surgery remains unclear.
Methods:
This single-center randomized controlled trial enrolled 120 patients undergoing elective laparoscopic surgery. After extubation under deep sedation, patients were randomized to receive either HFNC or NC until discharge from the post-anesthesia care unit (PACU). Extubation under deep sedation was performed during emergence after discontinuation of anesthetic agents, when patients had regained spontaneous respiration but had not yet fully recovered consciousness, according to predefined clinical and bispectral index criteria.The primary outcome was hypoxemia, defined as peripheral oxygen saturation (SpO₂) < 90% for > 60 s between extubation and PACU discharge. Secondary outcomes included arterial partial pressure of oxygen/inspired oxygen fraction (PaO₂/FiO₂), arterial partial pressure of carbon dioxide (PaCO₂), heart rate, mean arterial pressure, and perioperative complications. Parameters were measured at six time points: before anesthesia (T0), immediately after extubation (T1), and at 5 (T2), 15 (T3), 30 (T4) minutes post-extubation, and at PACU discharge (T5).
Results:
Hypoxemia occurred in 24/60 (40%) NC patients and 12/60 (20%) HFNC patients (P = 0.028). Of those, mask-assisted positive pressure ventilation was needed in 11/24 NC and 2/12 HFNC patients (P = 0.026); jaw thrust was performed in 13/24 and 10/12, respectively. At T2 and T3, PaO₂/FiO₂ was higher (T2: 333.0 ± 34.6 vs. 286.3 ± 41.7; T3: 345.9 ± 34.5 vs. 303.2 ± 40.3 mmHg; both P < 0.001) and PaCO₂ lower (T2: 42.2 ± 4.2 vs. 48.8 ± 3.8; T3: 39.6 ± 3.7 vs. 45.3 ± 3.6 mmHg; both P < 0.001) in the HFNC group. No differences were found in PACU stay or other complications.
Conclusions:
HFNC oxygen therapy after extubation under deep sedation significantly reduces hypoxemia and improves early respiratory function versus NC, with comparable safety.
Trial Registration:
Chinese Clinical Trial Registry (ChiCTR2500107249, August 7, 2025).
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
01:29Administering Oxygen by Nasal Cannula
Nasal Cannulas
A nasal cannula is a lightweight tube split into two prongs placed in the nostrils,...
01:24Endotracheal Tube Extubation
Procedure
Extubation removes the endotracheal tube (ETT) from the patient on mechanical ventilation. It requires a well-coordinated, multidisciplinary approach involving physicians, nurses, respiratory therapists, and other healthcare professionals....
01:26Oxygen Delivering System I: Nasal Cannula and Face Mask
Nasal Cannula
A nasal cannula is a lightweight tube split at one end into two prongs and placed in the nostrils. It is typically used to deliver low to medium levels of oxygen.
Suggested flow rate: The suggested flow rate for a nasal cannula typically ranges between 1 and 6 L/min.
Oxygen percentage setting:...
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,...
01:17Endotracheal Intubation II: Nursing Management
1. Nursing Care of Patients Before Intubation
Before the endotracheal intubation procedure, nurses play an essential role in ensuring the process goes smoothly. The nurses must be familiar with intubation...
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...