Wang Jiangling, Wu Qicheng, Ding Zewu, Zhang Wen, Xie Kangjie, Mao Xiaochun, Fang Xiangming
Department of Anesthesia, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Department of Anesthesiology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, China.
Front Med (Lausanne). 2025 Jul 23;12:1517819. doi: 10.3389/fmed.2025.1517819. eCollection 2025.
The majority of percutaneous radiofrequency ablation (PRFA) procedures for liver cancer are performed under ultrasound guidance and with moderate sedation. Oxygen desaturation is one of the most common and concerning adverse events that can be challenging to prevent during this procedure. High-flow nasal cannula (HFNC) oxygen therapy is effective in delivering high oxygen flow rates. This study aimed to evaluate the safety of HFNC oxygen therapy in preventing oxygen desaturation in patients undergoing ultrasound-guided PRFA with moderate sedation.
In this prospective, randomized controlled study, 100 patients who underwent ultrasound-guided PRFA with moderate sedation were randomly divided into two groups: a low-flow oxygen group (6 L/min via an HFNC) and a high-flow oxygen group (40 L/min via an HFNC). The primary outcome was oxygen desaturation. Other adverse events were also recorded.
Patients who received high-flow oxygen (40 L/min) had a lower incidence of mild desaturation (0% vs. 6%, = 0.24), moderate desaturation (4% vs. 30%; RR 7.5, 95% CI 2.07, 28.58, = 0.0009), and severe desaturation (0% vs. 4%, = 0.5) compared to those who received low-flow oxygen (6 L/min). Average oxygen saturation (SpO2) was significantly higher in the high-flow group ( < 0.0001). No significant differences were observed in other adverse events or perioperative variables.
In patients undergoing ultrasound-guided PRFA with moderate sedation, high-flow oxygen therapy at 40 L/min through HFNC therapy resulted in higher average oxygen saturation levels and a reduced incidence of oxygen desaturation-particularly moderate and severe desaturation-compared to low-flow oxygen therapy at 6 L/min.
Identifier NCT05212064.
大多数肝癌经皮射频消融（PRFA）手术是在超声引导下并使用适度镇静进行的。氧饱和度降低是该手术过程中最常见且令人担忧的不良事件之一，在手术期间预防具有挑战性。高流量鼻导管（HFNC）氧疗可有效提供高氧流量。本研究旨在评估HFNC氧疗在预防接受超声引导下PRFA并适度镇静患者氧饱和度降低方面的安全性。
在这项前瞻性随机对照研究中，100例接受超声引导下PRFA并适度镇静的患者被随机分为两组：低流量氧组（通过HFNC以6 L/分钟）和高流量氧组（通过HFNC以40 L/分钟）。主要结局是氧饱和度降低。还记录了其他不良事件。
与接受低流量氧（6 L/分钟）的患者相比，接受高流量氧（40 L/分钟）的患者轻度氧饱和度降低的发生率更低（0%对6%，P = 0.24），中度氧饱和度降低（4%对30%；RR 7.5，95% CI 2.07，28.58，P = 0.0009），以及重度氧饱和度降低（0%对4%，P = 0.5）。高流量组的平均血氧饱和度（SpO2）显著更高（P < 0.0001）。在其他不良事件或围手术期变量方面未观察到显著差异。
在接受超声引导下PRFA并适度镇静的患者中，与6 L/分钟的低流量氧疗相比，通过HFNC以40 L/分钟进行高流量氧疗导致更高的平均血氧饱和度水平，并降低了氧饱和度降低的发生率，尤其是中度和重度氧饱和度降低。
标识符NCT05212064。
