6/29/23, 11:57 PM Simon Pathway Feedback Search Clinical Topics Home Studies Simon Simon Trial question What is the role of a high-flow nasal cannula for preoxygenation before intubation in patients with hypoxemic respiratory failure? Study design Single center Open label RCT Population Characteristics of study participants 45.0% female N = 40 55.0% male 40 patients (18 female, 22 male) Inclusion criteria: critically ill subjects with hypoxemic respiratory failure Key exclusion criteria: blocked nasopharynx, contraindications for nose-mouth mask or high flow nasal cannula oxygen, expected difficult airway, emergency endotracheal intubation Interventions N=20 high-flow nasal cannula (an Optiflow system for preoxygenation with oxygen flow set to 50 L/min) N=20 bag-valve-mask (AMBU SPUR II disposable resuscitator for preoxygenation with oxygen flow set at 10 L/min) Primary outcome Mean lowest oxygen saturation during intubation 89.0 % 89 86 66.8 % 44.5 % https://web.pathway.md/studies/rec2L2Dg0NqIwnJHl 1/2 6/29/23, 11:57 PM Simon Pathway 22.3 % No significant difference 0.0 % High-flow nasal cannula Bag-valve-mask No significant difference in mean lowest oxygen saturation during intubation (89% vs. 86%; AD 3%, 95% CI -6.8 to 12.8) Secondary outcomes No significant difference in mean duration of intubation (30 s vs. 37 s; AD -7 s, 95% CI -21.51 to 7.51) No significant difference in abortion of apnea phase and emergency intubation due to progressive hypoxemia (10% vs. 5%; AD 5%, 95% CI -10.95 to 20.95) Safety outcomes No significant differences in time points before and after intubation concerning oxygen saturation, the ratio of the partial pressure of oxygen and FiO2, and partial pressure of CO2. Conclusion In critically ill subjects with hypoxemic respiratory failure, high-flow nasal cannula was not superior to bag-valve-mask with respect to mean lowest oxygen saturation during intubation. Reference Marcel Simon, Christian Wachs, Stephan Braune et al. High-Flow Nasal Cannula Versus Bag-Valve- Mask for Preoxygenation Before Intubation in Subjects With Hypoxemic Respiratory Failure. Respir Care. 2016 Sep;61(9):1160-7. Open reference URL https://web.pathway.md/studies/rec2L2Dg0NqIwnJHl 2/2