Anaes Vivas · Airway management
THRIVE for the difficult airway — clinical viva
A clinical viva on integrating THRIVE into the anticipated-difficult-airway plan: thorough preoxygenation of the high-risk patient, the apnoeic intubation sequence, the physiology that buys the time, and the limits that keep the team honest.
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Prompt
A patient with a predicted difficult airway (retrognathia, limited neck extension, previous documented difficult intubation) presents for elective surgery. Describe how you would use preoxygenation and apnoeic oxygenation with THRIVE in your airway plan.
Stimulus
A patient with a predicted difficult airway (retrognathia, limited neck extension, previous documented difficult intubation) presents for elective surgery. Describe how you would use preoxygenation and apnoeic oxygenation with THRIVE in your airway plan[1][2].
References4ShowHide
- [1]Campanella A, Guglielmi R, Zattera L, Jacas A, Ferrando C High-Flow Nasal Oxygen in the Perioperative Setting: A Narrative Review. Anaest Crit Care Pain Med, 2026.PMID 41903885
- [2]Gutierrez L, Chittal A, Fiore S, Tiberio P Preoxygenation When Standard Approaches Fail: Phenotype-Based Strategies for High-Risk Emergent Intubations. J Clin Med, 2026.PMID 41976778
- [3]Salhotra R, Kemprai R, Rautela R, Kapoor R, Armo M Comparative efficacy of NO-DESAT and THRIVE for peri-oxygenation in patients with anticipated difficult airway. Indian J Anaesth, 2026.PMID 42145287
- [4]Patel A, Nouraei SA Transnasal Humidified Rapid-Insufflation Ventilatory Exchange (THRIVE): a physiological method of increasing apnoea time in patients with difficult airways. Anaesthesia, 2015.PMID 25388828