Park Sujung, Kim So Yeon, Kim Hyun Joo
Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, South Korea.
Sleep Breath. 2023 Oct;27(5):1779-1785. doi: 10.1007/s11325-023-02785-5. Epub 2023 Feb 3.
High-flow nasal oxygenation (HFNO) can provide a low level of continuous positive airway pressure and alveolar recruitment. We aimed to compare the efficacy of pre-oxygenation with HFNO and low-flow nasal oxygenation (LFNO) during drug-induced sleep endoscopy (DISE).
In the LFNO group, preoxygenation was performed for 10 min at 3 L·min. In the HFNO group, preoxygenation was performed for 10 min at 30 L·min at a fraction of inspired oxygen of 100% using the Optiflow device. From the start of sedative administration to the end of DISE, vital signs were monitored continuously. The primary outcome was the lowest oxygen saturation (SpO) during DISE.
Of 24 patients enrolled, 12 were randomly assigned to the LFNO and 12 to the HFNO groups. The prevalence of hypoxia events was 75% in the LFNO group and 58% in the HFNO group. The difference in lowest oxygen saturation between the two groups was not significant between the two groups (P=0.665). The lowest SpO during all procedures was comparable between the two groups (86.8 ± 6.5% in the LFNO group and 87.2 ± 8.0% in the HFNO group; P=0.912).
The findings suggest that HFNO may not be superior to LFNO as a preoxygenation tool to prevent hypoxia during DISE.
高流量鼻导管给氧（HFNO）可提供低水平的持续气道正压通气并促进肺泡复张。我们旨在比较药物诱导睡眠内镜检查（DISE）期间HFNO与低流量鼻导管给氧（LFNO）进行预给氧的效果。
在LFNO组中，以3 L·min的流量进行10分钟的预给氧。在HFNO组中，使用Optiflow设备以30 L·min的流量、100%的吸入氧分数进行10分钟的预给氧。从开始给予镇静剂到DISE结束，持续监测生命体征。主要结局是DISE期间的最低血氧饱和度（SpO）。
在纳入的24例患者中，12例被随机分配到LFNO组，12例被分配到HFNO组。LFNO组缺氧事件的发生率为75%，HFNO组为58%。两组之间最低血氧饱和度的差异无统计学意义（P=0.665）。两组在所有操作过程中的最低SpO相当（LFNO组为86.8±6.5%，HFNO组为87.2±8.0%；P=0.912）。
研究结果表明，作为预防DISE期间缺氧的预给氧工具，HFNO可能并不优于LFNO。
