Department of Anesthesiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China; Department of Anesthesiology, Peking Union Medical College Hospital, Beijing, China.
Department of Anesthesiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Gastrointest Endosc. 2024 Jun;99(6):989-997. doi: 10.1016/j.gie.2023.12.014. Epub 2023 Dec 13.
Hypoxemia is one of the most common adverse events during colonoscopy, particularly among patients who are diagnosed with obstructive sleep apnea (OSA) or are overweight. Consequently, the objective of this study was to evaluate the effectiveness of bilevel positive airway pressure (BPAP) ventilation for patients with high-risk hypoxemia during colonoscopy with sedation.
In this trial, 127 patients who met the eligibility criteria were randomly assigned to the BPAP oxygen group and nasal cannula (NC) group. The primary endpoint was the incidence of hypoxemia.
Compared with the use of NC, BPAP ventilation exhibited a significant reduction in the incidence of hypoxemia, decreasing it from 23.8% to 6.3% (absolute risk difference, 17.5%; 95% confidence interval, 5.4-29.6; P = .006). Importantly, BPAP ventilation prevented the occurrence of severe hypoxemia (9.5% vs 0%; absolute risk difference, 9.5%; 95% confidence interval, 2.3-16.7; P = .035). In addition, the BPAP group required fewer airway interventions (P < .05).
In individuals with OSA or overweight status, the use of BPAP ventilation during colonoscopy significantly reduced the incidence of hypoxemia. (Clinical trial registration number: ChiCTR2300073193.).
低氧血症是结肠镜检查中最常见的不良事件之一，尤其是在诊断为阻塞性睡眠呼吸暂停（OSA）或超重的患者中。因此，本研究旨在评估双水平气道正压通气（BPAP）在镇静状态下结肠镜检查中高危低氧血症患者中的有效性。
在这项试验中，符合入选标准的 127 名患者被随机分配至 BPAP 吸氧组和鼻导管（NC）组。主要终点是低氧血症的发生率。
与使用 NC 相比，BPAP 通气显著降低了低氧血症的发生率，从 23.8%降至 6.3%（绝对风险差异，17.5%；95%置信区间，5.4-29.6；P =.006）。重要的是，BPAP 通气预防了严重低氧血症的发生（9.5%比 0%；绝对风险差异，9.5%；95%置信区间，2.3-16.7；P =.035）。此外，BPAP 组需要的气道干预更少（P <.05）。
在 OSA 或超重患者中，结肠镜检查时使用 BPAP 通气可显著降低低氧血症的发生率。（临床试验注册号：ChiCTR2300073193.）。
