The Journal of emergency medicine · 2026
High-Flow Nasal Cannula Therapy for Apneic Oxygenation during Rapid Sequence Induction in the Emergency Department: A Systematic Review.
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Geary April, Hicks Harriet, Tebbett Alexandra
Аннотация
BACKGROUND: Rapid sequence induction (RSI) is a critical procedure in the emergency department (ED). The use of high-flow nasal cannula (HFNC) oxygen therapy has emerged as a means of pre- and apneic oxygenation during RSI. Considering the unique environment of the ED, it is essential to understand whether there is a clinical benefit to using HFNC during RSI in the ED to guide clinical practice.
OBJECTIVES: This systematic review aims to evaluate the efficacy of HFNC as an oxygenation therapy during the apneic phase of RSI in the ED compared with existing preoxygenation therapies.
METHODS: A comprehensive literature search was conducted across five databases on October 13, 2025 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
RESULTS: Four studies (500 patients) met the inclusion criteria. Two of the four studies reported increased safe apnea duration with HFNC (p = 0.006 and p = 0.104). However, there were no observed changes in clinical outcomes, such as mortality rates and the number of desaturation events.
CONCLUSION: HFNC may be considered as an oxygenation strategy during the apneic period of RSI in the ED, although evidence for a clinically meaningful benefit remains limited.
OBJECTIVES: This systematic review aims to evaluate the efficacy of HFNC as an oxygenation therapy during the apneic phase of RSI in the ED compared with existing preoxygenation therapies.
METHODS: A comprehensive literature search was conducted across five databases on October 13, 2025 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
RESULTS: Four studies (500 patients) met the inclusion criteria. Two of the four studies reported increased safe apnea duration with HFNC (p = 0.006 and p = 0.104). However, there were no observed changes in clinical outcomes, such as mortality rates and the number of desaturation events.
CONCLUSION: HFNC may be considered as an oxygenation strategy during the apneic period of RSI in the ED, although evidence for a clinically meaningful benefit remains limited.