Minerva anestesiologica · 2025
Comparison of high flow nasal cannula versus procedural oxygen mask for hypoxemia prevention during endoscopic retrograde cholangiopancreatography: a randomized parallel-group trial.
СтатьяРандомизированное исследованиеСравнительное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Gunel Bedirhan, Sencan Ayse, Cevik Tunahan, Islamoglu Zeki, Yilmaz Mehmet
Аннотация
BACKGROUND: This study investigated the effects of high-flow nasal cannula (HFNC) and Procedural Oxygen Mask™ (POM™) on oxygenation during endoscopic retrograde cholangiopancreatography (ERCP) performed under sedation in the semi-prone position.
METHODS: In this prospective, randomized, parallel-group trial, 198 patients scheduled for ERCP between March 7th and June 3rd, 2025, were assessed; 150 were randomized to receive oxygen via HFNC or POM™ (75 each). The primary outcome was the incidence of hypoxemia (SpO<inf>2</inf><90% for ≥10 seconds) during ERCP. Secondary outcomes included the duration of hypoxemia, the number of hypoxemic episodes per patient, and the lowest recorded SpO<inf>2</inf>, along with the incidence of airway interventions, the incidence of procedure-disrupting body motions, hemodynamic changes, and satisfaction scores from both gastroenterologists and patients.
RESULTS: Hypoxemia occurred in five patients (6.7%) in the HFNC group and in one patient (1.3%) in the POM™ group; however, this difference was not statistically significant (P=0.209). No significant differences were found in any secondary outcomes between the groups (P>0.003). In multiple logistic regression analysis, only weight was significantly associated with hypoxemia risk (aOR=1.091; 95% CI: 1.001-1.189; P=0.048), while no significant difference was found between the HFNC and POMTM groups (aOR=9.357; 95% CI: 0.815-107.447; P=0.073).
CONCLUSIONS: POM™ appears to be a practical alternative to HFNC for oxygen supplementation during ERCP under sedation in the semi-prone position, with comparable hypoxemia incidence and airway-related outcomes. These results suggest that POM™ can be effectively used in this clinical setting.
METHODS: In this prospective, randomized, parallel-group trial, 198 patients scheduled for ERCP between March 7th and June 3rd, 2025, were assessed; 150 were randomized to receive oxygen via HFNC or POM™ (75 each). The primary outcome was the incidence of hypoxemia (SpO<inf>2</inf><90% for ≥10 seconds) during ERCP. Secondary outcomes included the duration of hypoxemia, the number of hypoxemic episodes per patient, and the lowest recorded SpO<inf>2</inf>, along with the incidence of airway interventions, the incidence of procedure-disrupting body motions, hemodynamic changes, and satisfaction scores from both gastroenterologists and patients.
RESULTS: Hypoxemia occurred in five patients (6.7%) in the HFNC group and in one patient (1.3%) in the POM™ group; however, this difference was not statistically significant (P=0.209). No significant differences were found in any secondary outcomes between the groups (P>0.003). In multiple logistic regression analysis, only weight was significantly associated with hypoxemia risk (aOR=1.091; 95% CI: 1.001-1.189; P=0.048), while no significant difference was found between the HFNC and POMTM groups (aOR=9.357; 95% CI: 0.815-107.447; P=0.073).
CONCLUSIONS: POM™ appears to be a practical alternative to HFNC for oxygen supplementation during ERCP under sedation in the semi-prone position, with comparable hypoxemia incidence and airway-related outcomes. These results suggest that POM™ can be effectively used in this clinical setting.