Bethany A Yon, Rachel K Johnson
Elementary and middle school children's acceptance of lower calorie flavored milk as measured by milk shipment and participation in the National School Lunch Program
The Journal of school health
tubeless upper airway surgery children complex procedure surgeons anaesthetists share operating field procedures often interrupted rescue oxygen therapy efficacy nasal highflow oxygen decrease frequency rescue interruptions children undergoing upper airway surgery unknown multicentre randomised trial conducted five tertiary hospitals australia children aged 016 years required tubeless upper airway surgery randomised 11 webbased randomisation tool either nasal highflow oxygen delivery standard oxygen therapy oxygen flows 6 lmin randomisation stratified site age 1 year 14 years 516 years subsequent tubeless upper airway surgery procedures child could included 2 weeks procedures repeat surgical procedures meeting condition considered independent events oxygen therapy could masked investigators remained blinded outcome data locked primary outcome successful anaesthesia without interruption surgical procedure rescue oxygenation rescue oxygenation event defined interruption surgical procedure deliver positive pressure ventilation using either bag mask technique insertion endotracheal tube laryngeal mask improve oxygenation ten secondary outcomes including proportion procedures hypoxaemic event spo2 90 analyses done intentiontotreat itt basis safety assessed enrolled participants trial registered australian new zealand clinical trials registry actrn12618000949280 completed sept 4 2018 april 12 2021 581 procedures 487 children randomly assigned highflow oxygen 297 procedures standard care 284 procedures exclusions 528 procedures 267 assigned highflow oxygen 261 assigned standard care 483 children 293 male 190 female included itt analysis primary outcome successful anaesthesia without interruption tubeless airway surgery achieved 236 88 267 procedures highflow oxygen 229 88 261 procedures standard care adjusted risk ratio rr 102 95 ci 096108 p082 51 19 procedures hypoxaemic event highflow oxygen group 57 22 standard care group rr 086 95 ci 058124 prespecified secondary outcomes none showed significant difference groups adverse events epistaxis laryngospasm bronchospasm hypoxaemia bradycardia cardiac arrest hypotension death similar study groups nasal highflow oxygen tubeless upper airway surgery reduce proportion interruptions procedures rescue oxygenation compared standard care differences adverse events intervention groups results suggest approaches nasal highflow standard oxygen suitable alternatives maintain oxygenation children undergoing upper airway surgery thrasher research fund australian new zealand college anaesthetists society paediatric anaesthesia new zealand australia