Comparing High-Flow Nasal Cannula and Conventional Oxygen to Prevent Low Oxygen Levels During Awake Tracheal Intubation in Adults with Difficult Airways

What this Trial Is About

The trial investigates the use of high-flow nasal cannula HFNC oxygen therapy compared with conventional low-flow nasal cannula oxygen therapy during awake tracheal intubation ATI in adults with anticipated difficult airways. ATI is a crucial procedure in anesthesia and emergency medicine, but hypoxemia during ATI remains a serious complication that may interrupt the procedure and increase risks. This study aims to provide high-quality evidence on whether HFNC can better prevent hypoxemia compared to conventional oxygen delivery. Participants will be randomly assigned to receive either heated and humidified high-flow nasal cannula oxygen at 40 Lmin with 100% oxygen and 37C temperature, or low-flow oxygen via disposable nasal cannula at 4 Lmin. Oxygen therapy starts before the intubation procedure and continues until successful intubation is confirmed by detecting end-tidal carbon dioxide. Two groups receive their assigned oxygen therapy throughout the ATI procedure. During the study, researchers will monitor participants from the start of ATI to successful intubation, assessing the incidence of hypoxemia oxygen saturation 90% as the primary outcome. Secondary outcomes include episodes of lower oxygen saturation, intubation success rates, intubation time, need for rescue interventions, and adverse events. The study is conducted at multiple hospitals and participants provide informed consent before enrollment. Monitoring lasts up to 30 minutes during ATI, with some measurements taken up to 24 hours after intubation.

High-flow Nasal Cannula Versus Conventional Oxygen During Awake Tracheal Intubation With Difficult Airways