Mohamed Ahmed M, Selima Wessam Z
Department of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Indian J Crit Care Med. 2025 Mar;29(3):223-229. doi: 10.5005/jp-journals-10071-24919. Epub 2025 Feb 28.
Hypoxemia is a common and serious complication occurring during deep sedation for prolonged upper gastrointestinal endoscopy (UGE). We evaluated and compared the efficacy of high-flow nasal cannula (HFNC) oxygen therapy vs conventional nasal cannula oxygen therapy (COT) in preventing hypoxemia in patients admitted to the intensive care unit (ICU) and who underwent prolonged (>15 minutes) UGE under deep sedation.
Seventy patients aged 20-60 years with American Society of Anesthesia (ASA) I, II, or III who were admitted to the ICU and were scheduled for an anticipated prolonged UGE were included. They were randomly assigned to be administered either oxygen through a standard nasal cannula (COT group) or oxygen through an HFNC (HFNC group). The primary outcome was any occurrence of at least moderate hypoxemic episodes [oxygen saturation (SpO) < 90%] of any duration.
Regarding the occurrence of hypoxemic episodes, 18 patients (51.4%) in the COT group experienced hypoxemia with 11 (31.4%) experiencing mild hypoxemia, six (17.1%) experiencing moderate hypoxemia, and only one patient (2.9%) experienced severe hypoxemia, with a total of seven patients (20.0%) whose SpO was <90%. Conversely, only two patients (5.7%) in the HFNC group had mild hypoxemia, and no patients had SpO < 90%. Additionally, nine patients in the COT group experienced clinically significant hypoxemia, whereas no patients in the HFNC group ( = 0.001).
High-flow nasal cannula (HFNC) oxygen therapy was safe, well tolerated, and significantly decreased the incidence of hypoxemic episodes, compared to COT, among high-risk ICU patients who underwent prolonged UGE under propofol deep sedation.( NCT06350864).
Mohamed AM, Selima WZ. HFNC Oxygen Therapy vs COT in Prolonged Upper Gastrointestinal Endoscopy Inside the ICU: A Prospective, Randomized, Controlled Clinical Study. Indian J Crit Care Med 2025;29(3):223-229.
低氧血症是长时间上消化道内镜检查（UGE）深度镇静期间常见且严重的并发症。我们评估并比较了高流量鼻导管（HFNC）氧疗与传统鼻导管氧疗（COT）在预防入住重症监护病房（ICU）且在深度镇静下接受长时间（>15分钟）UGE患者低氧血症方面的疗效。
纳入70例年龄在20 - 60岁、美国麻醉医师协会（ASA）分级为I、II或III级、入住ICU且计划进行预期长时间UGE的患者。他们被随机分配通过标准鼻导管吸氧（COT组）或通过HFNC吸氧（HFNC组）。主要结局是出现任何持续时间的至少中度低氧血症发作[血氧饱和度（SpO）<90%]。
关于低氧血症发作情况，COT组有18例患者（51.4%）发生低氧血症，其中11例（31.4%）为轻度低氧血症，6例（17.1%）为中度低氧血症，仅1例患者（2.9%）为重度低氧血症，共有7例患者（20.0%）的SpO <90%。相反，HFNC组仅有2例患者（5.7%）出现轻度低氧血症，且无患者SpO <90%。此外，COT组有9例患者发生具有临床意义的低氧血症，而HFNC组无患者发生（P = 0.001）。
与COT相比，高流量鼻导管（HFNC）氧疗安全、耐受性良好，且在接受丙泊酚深度镇静的长时间UGE的高危ICU患者中显著降低了低氧血症发作的发生率（NCT06350864）。
Mohamed AM, Selima WZ. HFNC Oxygen Therapy vs COT in Prolonged Upper Gastrointestinal Endoscopy Inside the ICU: A Prospective, Randomized, Controlled Clinical Study. Indian J Crit Care Med 2025;29(3):223 - 229.
