Prasert SawasdiwipachaiRatchaya WeerayutwattanaPunnarerk ThongcharoenSirilak SuksompongSiriraj HospitalVajira Hospital2022-08-042022-08-042021-10-01Journal of Cardiothoracic and Vascular Anesthesia. Vol.35, No.10 (2021), 2945-295115328422105307702-s2.0-85105586228https://repository.li.mahidol.ac.th/handle/20.500.14594/77838Objective: This study assessed the efficacy of high-flow humidified oxygen (HFHO) as an alternative to continuous positive airway pressure (CPAP) for improving oxygenation while preserving nonventilated lung collapse during one-lung ventilation. Design: A prospective randomized cross-over trial. Setting: A tertiary medical center. Participants: The study comprised 28 patients undergoing elective thoracotomy with one-lung ventilation using a double-lumen endobronchial tube placement. Interventions: The patients received prophylactic CPAP or HFHO to the nonventilated lung for 20 minutes and were then crossedover to the other oxygenation modality for 20 minutes, with a 20-minute recovery interval between the two modalities. Measurements and Main Results: Changes in respiratory parameters and lung deflation quality were recorded. Both CPAP and HFHO increased the partial pressure of arterial oxygen in either sequence in both groups, ranging from 31.8-to-66.0 mmHg. However, the increments from these two interventions were not statistically significant (95% confidence interval –12.84 to 21.87; p = 0.597). There were no differences in other parameters. Half the patients receiving CPAP experienced worsening of the surgical condition, whereas the HFHO patients experienced no change or reported a better lung deflation (p < 0.001). Conclusion: HFHO could be an alternative method to CPAP for improving arterial oxygenation while preserving lung deflation during one-lung ventilation. However, additional studies are warranted in regard to its cost-effectiveness and establishment as a routine treatment.Mahidol UniversityMedicineArticleSCOPUS10.1053/j.jvca.2021.04.001