[Application of transnasal humidified rapid-insufflation ventilatory exchange in anesthesia for juvenile-onset recurrent respiratory papillomatosis surgery].

This study evaluated the application of transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) for apneic oxygenation during anesthesia in pediatric surgery for juvenile-onset recurrent respiratory papillomatosis (JORRP). A retrospective analysis included 55 pediatric patients (27 males, 28 females) aged under 12 years who underwent JORRP surgery with THRIVE at Beijing Tongren Hospital between January 2023 and December 2024. Data on patient demographics, surgical details, lowest intraoperative SpO2, heart rate and mean arterial pressure (MAP) at various time points (before and after anesthesia induction, at the start of surgery, at 5, 10, 20, and 30 minutes after surgery began, at the end of surgery, and upon leaving the operating room), number of extubations, and apnea duration were collected. The median age was 7 (IQR 6-10) years, with preoperative laryngeal obstruction grades ranging from Ⅰ to Ⅲ, including 35 patients (63.6%) with grade II or above. Median apnea time was 9 (IQR 8-12) minutes, and 50 patients (90.9%) required only one intraoperative extubation. The lowest SpO2 was≥90% in 52 patients (94.6%), including 44 (80.0%) maintaining SpO2 at 95%-100%. Intraoperative hypoxemia (SpO2<92%) occurred in 5 patients (9.1%), with no serious THRIVE-related cardiopulmonary complications. Heart rate and MAP showed statistically significant variations across time points (all P<0.001). THRIVE effectively maintained oxygenation and circulation during apnea in pediatric patients with grade Ⅰ to Ⅲ laryngeal obstruction due to JORRP, reducing the need for repeated intubation and proving to be a safe and effective ventilatory support method.