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Comparison of high flow nasal oxygen and conventional nasal cannula during gastrointestinal endoscopic sedation in the prone position: a randomized trial

Authors
 Seung Hyun Kim  ;  Seungmin Bang  ;  Ki-Young Lee  ;  Seung Woo Park  ;  Jeong Youp Park  ;  Hee Seung Lee  ;  Hanseul Oh  ;  Young Jun Oh 
Citation
 CANADIAN JOURNAL OF ANESTHESIA-JOURNAL CANADIEN D ANESTHESIE, Vol.68(4) : 460-466, 2021-04 
Journal Title
 CANADIAN JOURNAL OF ANESTHESIA-JOURNAL CANADIEN D ANESTHESIE 
ISSN
 0832-610X 
Issue Date
2021-04
Keywords
endoscopy ; high flow nasal oxygen ; sedation
Abstract
Purpose: Deep sedation for endoscopic retrograde cholangiopancreatography (ERCP) can be challenging in elderly patients in the prone position. This study investigated the effect of a high flow nasal oxygen (HFNO) delivery system on oxygenation in this procedure compared with that of conventional nasal cannula oxygen administration. Methods: A prospective randomized trial was conducted using HFNO and conventional nasal cannula in patients undergoing ERCP in the prone position. For each patient, the lowest oxygen saturation (SpO2), the incidence of hypoxemia defined as an SpO2 below 90%, and interruptions due to airway interventions were recorded during the procedure. Results: The lowest mean (standard deviation) SpO2 recorded during the procedure was higher in the HFNO group than in the conventional control group [99.8 (0.6)% vs 95.1 (7.3)%; mean difference, 4.7%; 95% confidence interval, 2.3% to 7.1%; P Group x Time < 0.001]. While the lowest SpO2 during the procedure was lower than the baseline SpO2 in the control group, the lowest SpO2 during the procedure was higher than the baseline SpO2 in the HFNO group. Hypoxemia occurred only in the control group (n = 7; 19%; P = 0.01). Procedural interruptions, including discontinuation of sedation, patient stimulation, and jaw thrusting, occurred only in the control group (n = 9 [25%], n = 10 [28%], and n = 10 [28%] cases, respectively; P = 0.001 for each). Conclusion: In contrast to conventional nasal cannula, high flow nasal oxygen provided adequate oxygenation without causing procedural interruptions during ERCP, suggesting that HFNO may be used as a standard oxygen delivery method during these procedures. Trial registration: www.ClinicalTrials.gov (NCT03872674); registered 11 March 2019.
Full Text
https://link.springer.com/article/10.1007%2Fs12630-020-01883-2
DOI
10.1007/s12630-020-01883-2
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Seung Hyun(김승현) ORCID logo https://orcid.org/0000-0003-2127-6324
Park, Seung Woo(박승우) ORCID logo https://orcid.org/0000-0001-8230-964X
Park, Jeong Youp(박정엽) ORCID logo https://orcid.org/0000-0003-0110-8606
Bang, Seungmin(방승민) ORCID logo https://orcid.org/0000-0001-5209-8351
Oh, Young Jun(오영준) ORCID logo https://orcid.org/0000-0002-6258-5695
Lee, Ki Young(이기영) ORCID logo https://orcid.org/0000-0003-4893-3195
Lee, Hee Seung(이희승) ORCID logo https://orcid.org/0000-0002-2825-3160
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/182333
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