Effect of High-Flow Nasal Cannula Oxygen Therapy On The Postoperative Atelectasis in Interventional Sclerotherapy: A Randomized Controlled Trial

Objective Children undergoing interventional treatment for vascular malformations (VMs) can easily develop perioperative atelectasis. High-flow nasal cannula (HFNC) oxygen therapy shows the potential to reduce perioperative atelectasis. The aim of our study was to explore the potential efficacy of HFNC oxygen therapy for reducing the incidence of perioperative atelectasis in Pediatric interventional treatment for vascular malformations. Methods This study was a prospective randomized controlled trial with patientblind structure. A total of 81 pediatric patients scheduled for interventional sclerotherapy for VMs were randomly divided into three groups: the mask oxygenation group (Group M) (n = 27), the endotracheal intubation group (Group T) (n = 27), and the HFNC group (Group H) (n = 27). The incidence of atelectasis was assessed at T ₁ (at the end of surgery) and T ₂ (upon discharge from the PACU).Other intraoperative and postoperative outcomes were also evaluated. Results A total of 80 pediatric surgical patients were included (26 patients in Group M, 27 patients in Group T, and 27 patients in Group H). At T ₂ , significant atelectasis was observed in 17, 24, and 24 pediatric patients in Groups H, M, and T, respectively (63% vs. 88.9% vs. 92.3%; P  = 0.011). The awakening time, PAED score, incidence of agitation during awakening, and incidence of postoperative nausea and vomiting in Group M and Group H were significantly lower than those in Group T ( P  < 0.05). Conclusion HFNC oxygen therapy can reduce the incidence of atelectasis after pediatric interventional procedures for vascular malformations, prevent excessive CO ₂ retention and other adverse reactions. Trial Registration: Chinese Clinical Trial Registration number: ChiCTR2300078634