{"title":"不同呼吸氧合技术下幽门周围氧含量、气管氧含量和安全呼吸时间的比较：一项随机非劣效对照研究。","authors":"Weilian Geng, Changxing Chen, Yaobing Chen, Xiaojuan Yu, Xinhua Yu, Shaoqiang Huang","doi":"10.1186/s12890-025-03934-0","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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).</p><p><strong>Methods: </strong>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).</p><p><strong>Results: </strong>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<sub>2</sub> and FtO<sub>2</sub> 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<sub>2</sub> at the end of the apnea was positively correlated with safe apnea time.</p><p><strong>Conclusion: </strong>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.</p><p><strong>Trial registration: </strong>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.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"451"},"PeriodicalIF":2.8000,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparison of periglottic oxygen fraction, tracheal oxygen fraction and safe apnea time under different apneic oxygenation techniques: a randomised non-inferiority controlled study.\",\"authors\":\"Weilian Geng, Changxing Chen, Yaobing Chen, Xiaojuan Yu, Xinhua Yu, Shaoqiang Huang\",\"doi\":\"10.1186/s12890-025-03934-0\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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).</p><p><strong>Methods: </strong>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).</p><p><strong>Results: </strong>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<sub>2</sub> and FtO<sub>2</sub> 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<sub>2</sub> at the end of the apnea was positively correlated with safe apnea time.</p><p><strong>Conclusion: </strong>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.</p><p><strong>Trial registration: </strong>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.</p>\",\"PeriodicalId\":9148,\"journal\":{\"name\":\"BMC Pulmonary Medicine\",\"volume\":\"25 1\",\"pages\":\"451\"},\"PeriodicalIF\":2.8000,\"publicationDate\":\"2025-10-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BMC Pulmonary Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s12890-025-03934-0\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"RESPIRATORY SYSTEM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Pulmonary Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12890-025-03934-0","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
引用次数: 0
摘要
背景：呼吸暂停氧合延长了安全的呼吸暂停时间，降低了气道管理中低氧血症的风险。本研究的主要目的是比较各种技术的安全呼吸暂停时间，而次要目的是评估幽门周围和气管氧含量（FgO₂和FtO₂）的组间差异。方法：这项随机、非效性试验纳入125名受试者，分为5组：改良鼻咽气道，氧浓度为10 L/min （Naso组），鼻插管氧浓度为2 L/min （L2组），5 L/min （L5组）和10 L/min （L10组），以及不添加氧的对照组（L0组）。结果：L10组的成功率低于Naso组（82.6% vs. 95.7%；风险差-13.0%;95%CI: -27.8% ~ 1.7%），未建立非效性，但安全呼吸暂停时间相似（15 [15 ~ 15]min vs 15 [15 ~ 15] min, P = 0.138）。L10组在安全呼吸时间为15 min方面表现优于L0、L2和L5组（分别为82.6%比0、8.7%和43.5%）；L10组的p2和FtO2低于Naso组，但高于L0、L2和L5组（呼吸暂停结束时的p2与安全呼吸暂停时间呈正相关）。结论：鼻插管速度为10 L/min，配合改良鼻咽气道，安全呼吸时间更长，FgO₂和FtO₂水平相对较高。较高的氧流量与增加的FgO₂、FtO₂和更长的安全呼吸暂停时间有关。试验注册：本研究于2023年1月9日获得复旦大学妇产科医院伦理委员会（2022-197）批准。该研究于2023年1月16日在ChiCTR注册（ChiCTR2300067642）。
Comparison of periglottic oxygen fraction, tracheal oxygen fraction and safe apnea time under different apneic oxygenation techniques: a randomised non-inferiority controlled study.
Background: 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).
Methods: 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).
Results: 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,FgO2 and FtO2 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). FgO2 at the end of the apnea was positively correlated with safe apnea time.
Conclusion: 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.
Trial registration: 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.
期刊介绍：
BMC Pulmonary Medicine is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of pulmonary and associated disorders, as well as related molecular genetics, pathophysiology, and epidemiology.
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