High-flow nasal cannula oxygen versus Venturi facemask in women with cardiovascular disease undergoing…

Randomized trialJournal of thoracic disease· Jun 2026

High-flow nasal cannula oxygen versus Venturi facemask in women with cardiovascular disease undergoing cesarean delivery under neuraxial anesthesia: a randomized controlled trial.

Xiaorui Zhou, He Jing, Jiakai Lu … Sheng Wang

Obstetric AnesthesiaRandomized trialTreatmentQ2IF 2.1

High-flow nasal cannula raised maternal blood oxygen more than facemask during cesarean sedation

High-flow nasal cannula oxygen versus Venturi facemask in women with cardiovascular disease undergoing cesarean delivery under neuraxial anesthesia: a randomized controlled trial.

Xiaorui Zhou … Sheng Wang

Journal of thoracic disease · Jun 2026

Background

Women with cardiovascular disease undergoing cesarean delivery under neuraxial anesthesia are vulnerable to perioperative hypoxemia, particularly during sedation after fetal delivery.

Methods

In this prospective single-blind randomized controlled trial, 44 women with cardiovascular disease undergoing elective cesarean delivery under neuraxial anesthesia were randomly assigned to HFNC [40 L/min, fraction of inspired oxygen (FiO 2 ) 0.40] or Venturi facemask oxygen (10 L/min, FiO 2 0.40).

n = 44 women

Results

high-flow nasal cannula raised maternal PaO2 well above facemask oxygen

MD 48.80 (95% CI 29.80 to 67.80)

null 0

29.80

67.80

CI excludes the null - significant

More results

98% (96-98%); Hodges-Lehmann difference 1.0%, 95% CI: 0.0-2.0%; P=0.02].

Arterial partial pressure of carbon dioxide (PaCO 2 ) during sedation did not differ significantly between groups.

More results

The incidence of hypotension, vasoactive drug use, airway interventions, postoperative organ injury markers, oxygen-interface tolerance scores, intensive care unit (intensive care unit) admission, and neonatal outcomes were similar.

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Conclusion · 1 of 3

In women with cardiovascular disease undergoing cesarean delivery under neuraxial anesthesia, HFNC significantly improved maternal PaO 2 during remimazolam sedation after fetal delivery compared with Venturi facemask oxygen.

Conclusion · 2 of 3

This physiological improvement was not accompanied by statistically significant reductions in airway interventions, maternal complications, intensive care unit admission, or adverse neonatal outcomes.

Conclusion · 3 of 3

Larger studies powered for clinical outcomes are needed.

High-flow nasal cannula oxygen versus Venturi facemask in women with cardiovascular disease undergoing cesarean delivery under neuraxial anesthesia: a randomized controlled trial.

High-flow nasal cannula oxygen versus Venturi facemask in women with cardiovascular disease undergoing cesarean delivery under neuraxial anesthesia: a randomized controlled trial.

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