- Title
- Effect of high-flow vs. low-flow nasal plus mouthguard oxygen therapy on hypoxaemia during sedation: a multicentre randomised controlled trial
- Creator
- Thiruvenkatarajan, V.; Dharmalingam, A.; Van Wijk , R. M.; Ludbrook, G.; Wong, D. T.; Quail, A.; Arenas, G.; Wahba, M.; Liu, W.-M.; Zaw, Y.; Steiner, R.; Tran, A.; Currie, J.; Kadam, V. R.
- Relation
- Anaesthesia Vol. 77, Issue 1, p. 46-53
- Publisher Link
- http://dx.doi.org/10.1111/anae.15527
- Publisher
- Wiley-Blackwell
- Resource Type
- journal article
- Date
- 2022
- Description
- Whether high-flow vs. low-flow nasal oxygen reduces hypoxaemia for sedation during endoscopic retrograde cholangiopancreatography is currently unknown. In this multicentre trial, 132 patients ASA physical status 3 or higher, BMI > 30 kg.m-2 or with known or suspected obstructive sleep apnoea were randomly allocated to high-flow nasal oxygen up to 60 l.min-1 at 100% FI O2 or low-flow nasal oxygen at 4 l.min-1 . The low-flow nasal oxygen group also received oxygen at 4 l.min-1 through an oxygenating mouthguard, totalling 8 l.min-1 . Primary outcome was hypoxaemia, defined as Sp O2 < 90% regardless of duration. Hypoxaemia occurred in 7.7% (5/65) of patients with high-flow and 9.1% (6/66) with low-flow nasal oxygen (percentage point difference -1.4%, 95%CI -10.9 to 8.0; p = 0.77). Between the groups, there were no significant differences in frequency of hypoxaemic episodes; lowest Sp O2 ; peak transcutaneous carbon dioxide; hypercarbia (transcutaneous carbon dioxide > 2.66 kPa from baseline); requirement of chin lift/jaw thrust; nasopharyngeal airway insertion; bag-mask ventilation; or tracheal intubation. Following adjustment for duration of the procedure, the primary outcome remained non-significant. In high-risk patients undergoing endoscopic retrograde cholangiopancreatography, oxygen therapy with high-flow nasal oxygen did not reduce the rate of hypoxaemia, hypercarbia or the need for airway interventions, compared with combined oral and nasal low-flow oxygen.
- Subject
- endoscopic retrograde cholangiopancreatography; high-flow nasal oxygen; high-risk patients; hypoxaemia; low-flow nasal oxygen
- Identifier
- http://hdl.handle.net/1959.13/1474002
- Identifier
- uon:49172
- Identifier
- ISSN:0003-2409
- Language
- eng
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