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

Authors :
Man-Jong Lee
Boram Cha
Joung-Ho Han
Jin-Seok Park
Mi Hwa Park
Chunwoo Yang
Seok Jeong
Jung Soo Kim
Sang Yong Cho
Source :
Digestive Diseases and Sciences. 67:4154-4160
Publication Year :
2021
Publisher :
Springer Science and Business Media LLC, 2021.

Abstract

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. 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. 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). 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).

Details

ISSN :
15732568 and 01632116
Volume :
67
Database :
OpenAIRE
Journal :
Digestive Diseases and Sciences
Accession number :
edsair.doi.dedup.....5213b6e79a38cdbc5f07af2b4bc17f28
Full Text :
https://doi.org/10.1007/s10620-021-07272-z