Geng Weilian, Chen Changxing, Chen Yaobing, Yu Xiaojuan, Yu Xinhua, Huang Shaoqiang
Department of Anaesthesiology, Obstetrics and Gynaecology Hospital of Fudan University, Shanghai, China.
Department of Emergency and Critical Care Medicine Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
BMC Pulm Med. 2025 Oct 3;25(1):451. doi: 10.1186/s12890-025-03934-0.
Apneic oxygenation prolongs safe apnea time and reduces hypoxemia risk during airway management. The primary objective of this study was to compare the safe apnea time among various techniques, while the secondary objective was to evaluate intergroup differences in periglottic and tracheal oxygen fractions (FgO₂ and FtO₂).
This randomized, non-inferiority trial enrolled 125 participants, assigned to five groups: modified nasopharyngeal airway with 10 L/min oxygen (Naso group), nasal cannula oxygenation at 2 L/min (L2 group), 5 L/min (L5 group), and 10 L/min (L10 group), and a control group without supplemental oxygen (L0 group).
The success rate in the L10 group was lower than that in the Naso group (82.6% vs. 95.7%; risk difference, -13.0%; 95%CI: -27.8% to 1.7%), and non-inferiority was not established, but had similar safe apnea times (15 [15 to 15] min vs 15 [15 to 15] min, P = 0.138).The L10 group demonstrated superior performance compared to the L0, L2, and L5 groups terms of achieving a safe apnea time of 15 min (82.6% vs 0、8.7% and 43.5%,respectively; P < 0.001). At all measured time points,FgO and FtO in the L10 group were lower than those in the Naso group, but higher than those in the L0, L2 and L5 groups (P < 0.001). FgO at the end of the apnea was positively correlated with safe apnea time.
The nasal cannula at 10 L/min, along with the modified nasopharyngeal airway, was associated with longer safe apnea times and relatively higher FgO₂ and FtO₂ levels. Higher oxygen flow rates were associated with increased FgO₂, FtO₂, and longer safe apnea duration.
The study was approved by the Ethics Committee of the Obstetrics and Gynaecology Hospital of Fudan University (2022-197) on January 9, 2023. The study was registered on ChiCTR (ChiCTR2300067642) on January 16, 2023.
呼吸暂停氧合可延长气道管理期间的安全呼吸暂停时间并降低低氧血症风险。本研究的主要目的是比较各种技术之间的安全呼吸暂停时间，次要目的是评估声门周围和气管内氧分数（FgO₂和FtO₂）的组间差异。
本随机、非劣效性试验纳入了125名参与者，分为五组：10L/min氧气的改良鼻咽气道组（鼻咽组）、2L/min鼻导管给氧组（L2组）、5L/min鼻导管给氧组（L5组）、10L/min鼻导管给氧组（L10组），以及无补充氧气的对照组（L0组）。
L10组的成功率低于鼻咽组（82.6%对95.7%；风险差异，-13.0%；95%CI：-27.8%至1.7%），未确立非劣效性，但安全呼吸暂停时间相似（15[15至15]分钟对15[15至15]分钟，P=0.138）。在实现15分钟安全呼吸暂停时间方面，L10组表现优于L0组、L2组和L5组（分别为82.6%对0、8.7%和43.5%；P<0.001）。在所有测量时间点，L10组的FgO和FtO均低于鼻咽组，但高于L0组、L2组和L5组（P<0.001）。呼吸暂停结束时的FgO与安全呼吸暂停时间呈正相关。
10L/min的鼻导管与改良鼻咽气道相关，可延长安全呼吸暂停时间，并使FgO₂和FtO₂水平相对较高。较高的氧流量与FgO₂、FtO₂升高及更长的安全呼吸暂停持续时间相关。
本研究于2023年1月9日获得复旦大学附属妇产科医院伦理委员会批准（2022-197）。本研究于2023年1月16日在中国临床试验注册中心注册（ChiCTR2300067642）。
