Comparison of different flow rates of transnasal humidified rapid-insufflation ventilatory exchange for prevention of hypoxemia in painless gastroscopy
10.3760/cma.j.cn321463-20210406-00983
- VernacularTitle:不同流速快充式经鼻湿化高流量通气在无痛胃镜检查中预防低氧血症的效果比较
- Author:
Xiajuan HU
1
;
Jialin YIN
;
Yong ZHANG
;
Yajie XU
;
Hongguang BAO
;
Xiaoliang WANG
Author Information
1. 南京医科大学附属南京医院 南京市第一医院麻醉科，南京 210006
- Keywords:
Gastroscopy;
Anesthesia, intravenous;
Hypoxia;
Transnasal humidified rapid-insufflation ventilatory exchange;
Flow rate
- From:
Chinese Journal of Digestive Endoscopy
2022;39(4):313-317
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical effect of different flow rates of transnasal humidified rapid-insufflation ventilatory exchange (Thrive) on hypoxic events during painless gastroscopy.Methods:Patients who underwent painless gastroscopy in Nanjing First Hospital from April to July 2020 were randomly selected by random number table method and assigned to Thrive groups of 30 L/min ( n=52), 50 L/min ( n=55) and 70 L/min ( n=54). The incidences of different degree of hypoxic events (including subclinical respiratory depression, hypoxia and severe hypoxia) and adverse events related to Thrive were recorded. Results:The total incidence of hypoxic events in the 70 L/min group was 0 (0/54), which was significantly lower than that in the 30 L/min group (21.3%, 11/52, χ2=12.75, P<0.001) and 50 L/min group (12.7%, 7/55, P=0.007). There were no significant differences in subclinical respiratory depression [13.5% (7/52) VS 5.5% (3/55), χ2=1.19, P=0.194] or hypoxia [7.7% (4/52) VS 7.3% (4/55), P=0.610] between 30 L/min group and 50 L/min group. No severe hypoxia occurred in any group. The oxygenation of patients with hypoxemia in 30 L/min and 50 L/min groups was improved (SpO 2>95%) after opening the airway by mandibular support. In addition, there were no significant differences in the incidence of adverse events except hypoxemia among the three groups ( P>0.05). Conclusion:The flow rates of Thrive of 30 L/min, 50 L/min, and 70 L/min can prevent the occurrence of severe hypoxia during painless gastroscopy, and the flow rate of 70 L/min can further reduce the incidence of subclinical respiratory depression.
