This prospective randomized controlled trial aims to compare the effectiveness of High-Flow Nasal Cannula (HFNC) versus Tight Face Mask (TFM) in maintaining oxygenation during rapid sequence induction (RSI) for endotracheal intubation in adult patients. Participants will be randomly assigned in a 1:1 ratio to receive either HFNC or TFM for preoxygenation before induction of anesthesia. The primary outcome is the lowest peripheral oxygen saturation (SpOâ‚‚) recorded from induction until successful endotracheal intubation. Secondary outcomes include the incidence of oxygen desaturation (<90%), duration of apnea, duration of laryngoscopy, intubation time, number of intubation attempts, and peri-intubation complications. The study will determine whether HFNC provides superior oxygenation compared with conventional face mask preoxygenation during RSI and may contribute to improving airway management protocols and patient safety.
Inclusion Criteria:
Exclusion Criteria:
This is an open-label trial because the oxygen delivery devices are visibly different, making blinding of participants and healthcare providers impractical. Outcome variables, including peripheral oxygen saturation (SpOâ‚‚), are objectively measured using standard pulse oximetry, minimizing measurement bias.
Participants randomized to this arm will receive preoxygenation using a heated, humidified high-flow nasal cannula delivering oxygen at 60 L/min with an FiOâ‚‚ of 100% for 3 minutes before rapid sequence induction. The HFNC will remain in place during induction and laryngoscopy until successful endotracheal intubation to provide continuous oxygenation throughout the apneic period.
Participants randomized to this arm will receive standard preoxygenation using a tightly fitting anesthesia face mask delivering 100% oxygen at 15 L/min for 3 minutes before rapid sequence induction. The face mask will be removed immediately before laryngoscopy according to routine clinical practice. These arm titles and descriptions are appropriate for ClinicalTrials.gov registration. The next step will be to link each arm to its corresponding Device Intervention (HFNC and Tight Face Mask).
PreOxygenation In RSI Anesthesia
Benefits of High Flow Nasal Cannula Oxygen for Preoxygenation During Intubation in Non Severely Hypoxemic Patients
Pre-oxygenation With High-flow Nasal Cannula in Adults During Rapid Sequence Induction Anesthesia
Oxygenation Efficacy of "Intrinseque Health" Non-Rebreathing Mask ("IHNRM")
High Flow Oxygen in Preoxygenation During Rapid Sequence Induction in Infants and Small Children
Apneic Oxygenation in the Emergency Department
High-flow Nasal Cannula for Pediatric Anesthetic Induction
High-flow Nasal Cannula Versus Conventional Oxygen During Awake Tracheal Intubation With Difficult Airways