Transnasal Humidified Rapid Insufflation Ventilatory Exchange (THRIVE) augments oxygenation in children with cyanotic heart disease during microdirect laryngoscopy and bronchoscopy

Children with congenital heart disease are at an increased risk of anesthetic morbidity [1]. Since these patients undergo multiple surgical interventions, they are also at increased risk of tracheal and supraglottic pathology [2]. Utilization of high flow nasal cannula (HFNC), also described as Transnasal Humidified Rapid Insufflation Ventilatory Exchange (THRIVE), has been previously described to reduce desaturations during microdirect laryngoscopy and bronchoscopy (MDLB) in infants [4]. Due to these patients' passive pulmonary venous return, an increase in pulmonary vascular resistance (PVR) from hypoxia can lead to cardiopulmonary demise.