<span class="paragraphSection">In this issue of the <span style="font-style:italic;">BJA</span>, Humphreys and colleagues<a href="#aew432-B1" class="reflinks"><sup>1</sup></a> present their data on the use of transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) (Fisher and Paykel Healthcare, Auckland, New Zealand) in children. THRIVE is a technique that uses rapidly insufflated, heated, humidified gases administered via high flow nasal cannula (HFNC) to achieve apnoeic oxygenation and ventilation. This is the first study to demonstrate that THRIVE is effective in prolonging the safe apnoeic time in children during airway management. The purpose of this editorial is to explore the processes contributing to oxygenation and ventilation achieved through THRIVE, and to discuss future applications for this potentially promising ventilatory technique.</span>
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