TY - JOUR T1 - Nasal high-flow therapy to Optimise Stability during Intubation: the NOSI pilot trial JF - Archives of Disease in Childhood - Fetal and Neonatal Edition JO - Arch Dis Child Fetal Neonatal Ed SP - 244 LP - 249 DO - 10.1136/archdischild-2022-324649 VL - 108 IS - 3 AU - Jason Foran AU - Carmel Maria Moore AU - Caitriona M Ni Chathasaigh AU - Shirley Moore AU - Jyothsna R Purna AU - Anna Curley Y1 - 2023/05/01 UR - http://fn.bmj.com/content/108/3/244.abstract N2 - Objective In adult patients with acute respiratory failure, nasal high-flow (NHF) therapy at the time of intubation can decrease the duration of hypoxia. The objective of this pilot study was to calculate duration of peripheral oxygen saturation below 75% during single and multiple intubation attempts in order to inform development of a larger definitive trial.Design and setting This double-blinded randomised controlled pilot trial was conducted at a single, tertiary neonatal centre from October 2020 to October 2021.Participants Infants undergoing oral intubation in neonatal intensive care were included. Infants with upper airway anomalies were excluded.Interventions Infants were randomly assigned (1:1) to have NHF 6 L/min, FiO2 1.0 or NHF 0 L/min (control) applied during intubation, stratified by gestational age (<34 weeks vs ≥34 weeks).Main outcome measures The primary outcome was duration of hypoxaemia of <75% up to the time of successful intubation,Results 43 infants were enrolled (26 <34 weeks and 17 ≥34 weeks) with 50 intubation episodes. In infants <34 weeks’ gestation, median duration of SpO2 of <75% was 29 s (0–126 s) vs 43 s (0–132 s) (p=0.78, intervention vs control). Median duration of SpO2 of <75% in babies ≥34 weeks’ gestation was 0 (0–32 s) vs 0 (0–20 s) (p=0.9, intervention vs control).Conclusion This pilot study showed that it is feasible to provide NHF during intubation attempts. No significant differences were noted in duration of oxygen saturation of <75% between groups; however, this trial was not powered to detect a difference. A larger, higher-powered blinded study is warranted.Data are available upon reasonable request. Data may be obtained from a third party and are not publicly available. Data are available from anna.curley@nmh.ie, upon reasonable request for uses approved by the study group. ER -