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Randomized Controlled Trial
. 2022 Aug;67(8):4154-4160.
doi: 10.1007/s10620-021-07272-z. Epub 2021 Nov 2.

Impact of High-Flow Nasal Cannula Oxygenation on the Prevention of Hypoxia During Endoscopic Retrograde Cholangiopancreatography in Elderly Patients: A Randomized Clinical Trial

Man-Jong Lee #  1 , Boram Cha #  2 , Jin-Seok Park  3 , Jung Soo Kim  1 , Sang Yong Cho  2 , Joung-Ho Han  4 , Mi Hwa Park  1 , Chunwoo Yang  5 , Seok Jeong  2
Affiliations
Randomized Controlled Trial

Impact of High-Flow Nasal Cannula Oxygenation on the Prevention of Hypoxia During Endoscopic Retrograde Cholangiopancreatography in Elderly Patients: A Randomized Clinical Trial

Man-Jong Lee et al. Dig Dis Sci. 2022 Aug.

Abstract

Background: Hypoxia is the most frequently occurring adverse effect during endoscopic retrograde cholangiopancreatography (ERCP) under sedation; thus, oxygen must be properly supplied to prevent a reduction of oxygen saturation. In this study, we intend to verify the preventive effect for hypoxia during ERCP, using a high-flow nasal cannula (HFNC), in elderly patients.

Methods: As a multicenter prospective randomized trial, patients who underwent ERCP with propofol-based sedation were randomly assigned into two groups: Patients in the HFNC group were supplied with oxygen via an HFNC, and those in the standard nasal cannula group were supplied with oxygen via a low-flow nasal cannula. The co-primary end points were the lowest oxygen saturation rate and hypoxia during the overall procedure.

Results: A total of 187 patients (HFNC group: 95; standard nasal cannula group: 92) were included in the analysis. Unexpected hypoxia events were more frequently observed among patients in the standard nasal cannula group than among patients in the HFNC group (13% vs. 4%, odds ratio 3.41, 95% confidence interval 1.06-11.00, p = 0.031). The mean of the lowest oxygen saturation rate during ERCP was significantly lower in the standard nasal cannula group than in the HFNC group (95% vs. 97%, p = 0.002).

Conclusion: Oxygen supplementation with an HFNC can prevent oxygen desaturation and hypoxia events in patients undergoing ERCP under sedation. Trial registration Clinical Research Information Service (CRIS; KCT0004960).

Keywords: Endoscopic retrograde cholangiopancreatography; High-flow nasal cannula; Hypoxia; Propofol sedation.

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References

    1. Martindale SJ. Anaesthetic considerations during endoscopic retrograde cholangiopancreatography. Anaesth Intensive Care. 2006;34:475–480. - DOI
    1. Dumonceau JM, Riphaus A, Schreiber F et al. Non-anesthesiologist administration of propofol for gastrointestinal endoscopy: European Society of Gastrointestinal Endoscopy, European Society of Gastroenterology and Endoscopy Nurses and Associates Guideline. Endoscopy. 2015;47:1175–1189. - DOI
    1. Lin OS. Sedation for routine gastrointestinal endoscopic procedures: a review on efficacy, safety, efficiency, cost and satisfaction. Intest Res. 2017;15:456–466. - DOI
    1. Burtea DE, Dimitriu A, Malos AE et al. Current role of non-anesthesiologist administered propofol sedation in advanced interventional endoscopy. World J Gastrointest Endosc. 2015;7:981–986. - DOI
    1. Amornyotin S. Sedation-related complications in gastrointestinal endoscopy. World J Gastrointest Endosc. 2013;5:527–533. - DOI

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