Kais Susan S, Klein Kenneth B, Rose Richard M, Endemann Sarah, Coyle Walter J
Division of Gastroenterology, Scripps Green Hospital, La Jolla, California, USA.
Endpoint, LLC, Bainbridge Island, Washington, USA.
Endoscopy. 2016 Jun;48(6):584-7. doi: 10.1055/s-0042-102533. Epub 2016 Apr 25.
Drugs administered during gastrointestinal procedures cause increased collapsibility of the upper airway, which may lead to respiratory impairment. We evaluated the ability of continuous negative external pressure (cNEP) to lessen respiratory impairment during screening colonoscopy.
The initial 24 patients served as controls, while the next 30 received cNEP. cNEP was delivered by a soft silicone collar placed over the anterior neck. The primary endpoint was the frequency of respiratory impairment, defined as either: (i) a decline from baseline of > 4 % in oxygen saturation, or (ii) apnea lasting ≥ 20 seconds.
Mean respiratory impairment episodes were 3.50 in the no-cNEP group vs. 1.92 in the cNEP group, a reduction of 45 % (P = 0.022). Apneas ≥ 20 seconds occurred in 74 % of the no-cNEP group and 28 % of the cNEP group (P = 0.002). While 42 % of the no-cNEP group required increased supplemental oxygen, this was true for only 10 % of the cNEP group (P = 0.01). cNEP adverse events were minimal.
During screening colonoscopy, sedation-related respiratory impairment is significantly reduced by cNEP.ClinicalTrials.gov NCT01895062.
在胃肠道检查过程中使用的药物会导致上呼吸道可塌陷性增加，这可能会导致呼吸功能受损。我们评估了持续外部负压（cNEP）在筛查结肠镜检查期间减轻呼吸功能受损的能力。
最初的24例患者作为对照组，接下来的30例接受cNEP治疗。cNEP通过放置在前颈部的柔软硅胶颈圈施加。主要终点是呼吸功能受损的频率，定义为：（i）血氧饱和度较基线下降>4%，或（ii）呼吸暂停持续≥20秒。
无cNEP组平均呼吸功能受损发作次数为3.50次，而cNEP组为1.92次，减少了45%（P = 0.022）。≥20秒的呼吸暂停在无cNEP组中占74%，在cNEP组中占28%（P = 0.002）。无cNEP组中有42%的患者需要增加吸氧，而cNEP组中只有10%（P = 0.01）。cNEP的不良事件极少。
在筛查结肠镜检查期间，cNEP可显著减轻与镇静相关的呼吸功能受损。ClinicalTrials.gov NCT01895062。
