Author:
Jiang Bailin,Li Yi,Ciren Deji,Dawa Ouzhu,Feng Yi,Laba Ciren
Abstract
Abstract
Background
Hypobaric hypoxia is common at high altitudes. Whether this exacerbates hypoxia during procedural sedation and whether hypoxia can be alleviated by the use of supraglottic jet oxygenation and ventilation (SJOV) are unknown. This study aimed to compare the incidence of hypoxia during gastrointestinal endoscopy under deep sedation at high altitudes with oxygen supply techniques using either a nasal cannula or SJOV.
Methods
This study was conducted from April 2022 to July 2022 in a tertiary hospital located 3650 m above sea level. Adult patients scheduled for routine gastrointestinal endoscopy under sedation were enrolled and randomized 1:1 to receive SJOV or a nasal cannula during sedation. Moderate hypoxia was the primary outcome, defined as an SPO2 of 75–89% for < 60 s. The secondary outcomes were respiratory-, cardiovascular-, and SJOV-related complications. The influence of characteristics regarding acclimatization to high altitudes (Tibetan ethnic group and erythrocytosis) on the occurrence of hypoxia was analyzed.
Results
None of the patients were lost to follow-up. A total of 72 patients were included in the analysis (36 patients in each group). There were 20 (27.8%) patients who experienced moderate hypoxia events. Significantly fewer hypoxic events occurred in the SJOV group than in the nasal cannula group [3 (8.3%) vs. 17 (47.2%), absolute risk difference (95% CI): − 38.9 (− 57.5, − 20.2) %, risk ratio (RR, 95% CI): 0.18 (0.06, 0.55), P < 0.001]. Significantly fewer patients in the SJOV group experienced mild hypoxia (P < 0.001) and severe hypoxia (P = 0.002). No serious adverse events occurred in either of the groups. The Tibetan ethnic group (P = 0.086) and erythrocytosis (P = 0.287) were not associated with the occurrence of hypoxia events.
Conclusions
The incidence of hypoxia was lower with SJOV than with nasal cannula in patients undergoing gastrointestinal endoscopy under deep sedation at high altitudes. The Tibetan ethnic group and erythrocytosis did not influence the occurrence of hypoxia.
Trial registration
This study was registered at ClinicalTrials.gov (NCT05304923) before enrollment by Dr. Yi Feng on 31/03/2022.
Publisher
Springer Science and Business Media LLC
Subject
Anesthesiology and Pain Medicine
Reference27 articles.
1. Early DS, Lightdale JR, Vargo JJ 2nd, Acosta RD, Chandrasekhara V, Chathadi KV, et al. Guidelines for sedation and anesthesia in GI endoscopy. Gastrointest Endosc. 2018;87(2):327–37.
2. Goudra B. Big sleep: beyond Propofol sedation during GI endoscopy. Dig Dis Sci. 2019;64(1):1–3.
3. Luks AM, Swenson ER, Bärtsch P. Acute high-altitude sickness. Eur Respir Rev. 2017;26(143):160096. https://doi.org/10.1183/16000617.0096-2016.
4. Bell GD, Bown S, Morden A, Coady T, Logan RF. Prevention of hypoxaemia during upper-gastrointestinal endoscopy by means of oxygen via nasal cannulae. Lancet (London, England). 1987;1(8540):1022–4.
5. Jiang B, Wei H. Oxygen therapy strategies and techniques to treat hypoxia in COVID-19 patients. Eur Rev Med Pharmacol Sci. 2020;24(19):10239–46.
Cited by
7 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献