Place of High-Flow Oxygen Therapy (HFOT) in the Perioperative Period: A Thoracic Surgery Case Report

High-flow oxygen therapy (HFOT) has emerged as a promising approach in perioperative respiratory management, particularly in preventing postoperative respiratory complications, although its application in thoracic surgery remains underexplored. We report the case of a 58-year-old female with a history of pulmonary tumor and metastatic bone disease who was admitted for thoracic surgery due to dyspnea (NYHA class III). Preoperative evaluation revealed poor general condition with stable hemodynamics. Given the elevated risk of respiratory complications, HFOT was initiated for both preoxygenation and apneic oxygenation during intubation. The patient underwent thoracoscopy with talc pleurodesis and was managed with intraoperative mechanical ventilation, followed by postoperative HFOT to prevent respiratory distress and support the transition to spontaneous breathing. HFOT effectively maintained oxygen saturation (SpO₂ 98-100%) throughout the perioperative period, with no episodes of hypoxemia or respiratory complications post-extubation. The patient remained stable, avoided reintubation, and was transferred to the thoracic surgery unit without requiring intensive care. This case suggests that HFOT may enhance oxygenation, reduce the risk of postoperative respiratory failure, and facilitate smoother recovery in thoracic surgery. Further studies are warranted to better define its role in this context.