Rescue oxygenation for hypoxaemia is common during anaesthesia for procedures in children with abnormal airways due to the complexity of balancing adequate depth of anaesthesia with maintenance of spontaneous breathing and providing an uninterrupted field of view for the proceduralist.
Inadvertent hypoxaemia during flexible bronchoscopy has implications for both procedural efficiency, efficacy, and patient safety. Infants and children desaturate more quickly than adults and are more prone to apnoea. Nasal High Flow oxygen insufflation can prolong safe apnoea time, preventing hypoxaemia and can facilitate oxygenation during anaesthesia for children with abnormal airways and lungs whilst spontaneously breathing. To date, there is no high-grade evidence comparing Nasal High Flow (NHF) with the standard face mask/laryngeal mask oxygen delivery techniques during flexible bronchoscopy.
The investigators aim to conduct a pilot randomised controlled trial, in 80 children, to establish feasibility of Nasal High Flow for children presenting for elective flexible bronchoscopy at Queensland Children’s Hospital and Perth Children’s Hospital. We will compare NHF with LMA/Facemask to determine if NHF is a feasible oxygenation technique and the incidence and severity of hypoxaemic events requiring rescue oxygenation. This has the potential to both improve both the safety and the success of these procedures for children.
Associate Professor Susan Humphreys, Queensland Children’s Hospital, Queensland, Professor Britta Regli von Ungern-Sternberg, Perth Children’s Hospital, WA, Professor Kristen Gibbens, Child Health Research Centre, The University of Queensland.
The project was awarded $A89,999 (including scholarship) through the ANZCA research grants program for 2022.