Department of Gastroenterology, Graduate School of Medicine, Chiba University, Inohana 1-8-1, Chiba, 260-8670, Japan.
Department of Anesthesiology, Graduate School of Medicine, Chiba University, Chiba, Japan.
Sci Rep. 2023 Jan 23;13(1):1265. doi: 10.1038/s41598-023-28213-y.
Nasal pressure signal is commonly used to evaluate obstructive sleep apnea. This study aimed to assess its safety for respiratory monitoring during sedation. A total of 45 adult patients undergoing sedation with propofol and fentanyl for invasive endoscopic procedures were enrolled. While both nasal pressure and capnograph signals were continuously recorded, only the nasal pressure signal was displayed. The primary outcome was the incidence of oxygen desaturation below 90%. The secondary outcomes were the ability to predict the desaturation and incidence of harmful events and false alarms, defined as an apnea waveform lasting more than 3 min without desaturation. Of the 45 participants, 43 completed the study. At least one desaturation event occurred in 12 patients (27.9%; 95% confidence interval 15.3-43.7%). In these 12 patients, more than half of the desaturation events were predictable in 9 patients by capnography and 11 patients by nasal pressure monitoring (p = 0.59). In the 43 patients, false alarms were detected in 7 patients with capnography and 11 patients with nasal pressure monitoring (p = 0.427). Harmful events unrelated to nasal pressure monitoring occurred in 2 patients. Nasal pressure monitoring is safe and possibly useful for respiratory monitoring despite false alarms during sedation.
鼻压力信号常用于评估阻塞性睡眠呼吸暂停。本研究旨在评估其在镇静状态下进行呼吸监测的安全性。共有 45 名接受异丙酚和芬太尼镇静的成年内窥镜检查患者参与了该研究。在连续记录鼻压力和二氧化碳描记信号的同时，仅显示鼻压力信号。主要结局是发生氧饱和度下降至 90%以下的发生率。次要结局是预测饱和度下降和有害事件及假警报的发生的能力，定义为无饱和度持续超过 3 分钟的呼吸暂停波形。在 45 名参与者中，43 名完成了研究。在 12 名患者中至少发生了一次饱和度下降事件（27.9%；95%置信区间 15.3-43.7%）。在这 12 名患者中，有 9 名患者的二氧化碳描记法和 11 名患者的鼻压力监测可预测超过一半的饱和度下降事件（p=0.59）。在 43 名患者中，有 7 名患者的二氧化碳描记法和 11 名患者的鼻压力监测出现假警报（p=0.427）。有 2 名患者发生了与鼻压力监测无关的有害事件。尽管在镇静过程中出现假警报，但鼻压力监测用于呼吸监测是安全且可能有用的。
