High-Flow Nasal Cannula in Subjects Undergoing Endoscopy With Intravenous Sedation.
Christian Rouphael, Elie Saliba, Marc Moukarzel et al.
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In 30 seconds
This single-center randomized trial compared conventional nasal oxygen with high-flow nasal cannula (HFNC) at two flow rates in 60 low-risk subjects undergoing ERCP with deep intravenous sedation. HFNC did not reduce the incidence of oxygen-saturation falls or improve the lowest measured saturation. Average procedural SpO₂ was higher with HFNC at 15 L/min and 60 L/min than with conventional oxygen (99.2 ± 0.2% and 99.6 ± 0.3% vs 97.4 ± 0.3%, both P < .001), with no significant difference between HFNC flow groups.
Key findings
- Oxygen-saturation falls and the lowest procedural SpO₂ did not differ among the three groups.
- Average SpO₂ was 99.2 ± 0.2% with HFNC at 15 L/min and 99.6 ± 0.3% at 60 L/min, versus 97.4 ± 0.3% with conventional oxygen (both P < .001).
- Average SpO₂ did not differ between the two HFNC groups (P = .26).
- Procedure duration, snoring scores, and subject and gastroenterologist satisfaction did not differ significantly among groups.
Why it matters
During deeply sedated ERCP, HFNC was associated with higher average oxygen saturation, but this did not translate into fewer saturation reductions or a higher lowest measured saturation. These results distinguish improvement in an average physiological measure from prevention of clinically relevant desaturation and help frame the evidence for HFNC in this procedural setting.
What to keep in mind
The trial was single-center and included low-risk subjects undergoing ERCP, limiting how broadly its findings can be applied.