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- Title
Trans-nasal Humidified Rapid Insufflation Ventilatory Exchange (THRIVE) and its Utility in Otolaryngology, Head and Neck Surgery: A Literature Review.
- Authors
Ananthapadmanabhan, Saikrishna; Kudpaje, Akshay; Raju, Dinesh; Smith, Mark; Riffat, Faruque; Novakovic, Daniel; Stokan, Murray; Palme, Carsten E.
- Abstract
High-flow nasal oxygen (HFNO) therapy is extensively used in critical care units for spontaneously breathing patients. Trans-nasal humidified rapid insufflation ventilatory exchange (THRIVE) is a method of apnoeic oxygenation with continuous nasal delivery of warmed, humidified oxygen at high-flow rates up to 70L/min. THRIVE extends the apnoeic window before desaturation occurs so that tubeless anaesthesia is possible. The advent of THRIVE has had a monumental impact on anaesthetic practice, with a diverse range of clinical applications and it has been incorporated into difficult airway guidelines. THRIVE has many applications in otolaryngology and head and neck surgery. It is used as a pre-oxygenation tool during induction in both anticipated and unanticipated difficult airway scenarios and as a method of oxygenation for tubeless anaesthesia in elective laryngotracheal and hypopharyngeal surgeries and during emergence from anaesthesia. In this scoping review of the literature, we aim to provide an overview on the utility of THRIVE in otolaryngology, including the underlying physiologic principles, current indications and limitations, and its feasibility and safety in different surgical contexts and specific population groups.
- Subjects
LITERATURE reviews; INTENSIVE care units; NASAL cannula; OTOLARYNGOLOGY; INSUFFLATION; NECK
- Publication
Indian Journal of Otolaryngology & Head & Neck Surgery, 2024, Vol 76, Issue 2, p1921
- ISSN
2231-3796
- Publication type
Article
- DOI
10.1007/s12070-023-04445-2