High-flow nasal oxygenation reduces the risk of desaturation in adults receiving procedural sedation: a meta-analysis of randomized controlled trials

Perioperative Medicine

El-Wui Loh¹  Chun-Cheng Li²  Yih-Giun Cherng²  Ying-Hsuan Tai²  Hsin-Yi Liu²  Jui-Tai Chen²  Wan-Chi Liu²  Hsien-Cheng Kuo²  Ka-Wai Tam³ 

[1] Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan;Department of Dentistry, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan;Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan;Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, No. 291, Zhongzheng Rd., Zhonghe District, 23561, New Taipei City, Taiwan;Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan;Division of General Surgery, Department of Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan;Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan;Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan;

关键词: Conscious sedation;    High-flow nasal cannula;    Hypoxia;    Oxygen therapy;    Patient satisfaction;   

DOI  :  10.1186/s13741-021-00212-5

来源: Springer

【 摘 要 】

BackgroundProcedural sedation reduces patients’ discomfort and anxiety, facilitating performance of the examination and intervention. However, it may also cause adverse events, including airway obstruction and hypoxia. We conducted this systematic review and meta-analysis to evaluate the efficacy of high-flow nasal oxygenation (HFNO) compared with that of standard oxygen therapy in adult patients undergoing procedural sedation.MethodsWe identified randomized controlled trials published before November 2020 based on PubMed, Embase, and Cochrane Library databases and ClinicalTrials.gov registry. Intraprocedural desaturation [peripheral oxygen saturation (SpO2) < 90%] was evaluated as the primary outcome. The secondary outcomes were the lowest SpO2, need for airway intervention, oxygen therapy-related complications, and patient, operator, and anesthetist’s satisfaction.ResultsSix trials with a total of 2633 patients were reviewed. Patients using HFNO compared with standard oxygen therapy had a significantly lower risk of intraprocedural desaturation [risk ratio 0.18, 95% confidence interval (CI) 0.04-0.87]. The lowest intraprocedural SpO2 in HFNO group was significantly higher than that in standard oxygen therapy group (mean difference 4.19%, 95% CI 1.74-6.65).ConclusionsCompared with standard oxygen therapy, HFNO may reduce the risk of desaturation and increase the lowest SpO2 in adult patients undergoing sedation for medical procedures.

【 授权许可】

CC BY