Safety and efficacy of high-flow nasal oxygen for pre-oxygenation before anesthesia induction: a meta-analysis
10.3760/cma.j.cn131073.20220430.00809
- VernacularTitle:经鼻高流量吸氧技术用于全麻诱导前预氧合的安全性和有效性：meta分析
- Author:
Zihan MU
1
;
Ju GAO
;
Xiaoping CHEN
;
Yali GE
Author Information
1. 大连医科大学研究生院，大连 116044
- Keywords:
Anesthesia, general;
Face mask ventilation;
High-flow nasal oxygen;
Pre-oxygenation;
Meta-analysis
- From:
Chinese Journal of Anesthesiology
2022;42(8):932-940
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To systematically review and evaluate the safety and efficacy of high-flow nasal oxygen (HFNO) for pre-oxygenation before anesthesia induction.Methods:Pubmed, Cochrane Library, Embase, China National Knowledge Infrastructure, Wanfang Database, China Science and Technology Journal Database and China Biomedical Literature Database were searched from inception to March 2022.All randomized controlled trials comparing HFNO and facemask ventilation for pre-oxygenation before anesthesia induction were collected.Two researchers independently assessed the quality of trials and extracted data.The primary outcome was the safe apnea time, the secondary outcomes were the lowest SpO 2 during intubation, oxygenation-related complications, patient comfort, PaO 2 and PaCO 2 before and after pre-oxygenation and after intubation.Meta-analysis was performed using RevMan 5.4 software. Results:Seventeen randomized controlled trials involving 843 patients were included in this meta-analysis.The results of meta-analysis showed that the safe apnea time was significantly longer ( MD=67.61, 95% CI 5.94-129.28, P=0.03), the lowest SpO 2 was higher during tracheal intubation ( MD=3.27, 95% CI 2.25-4.29, P<0.01), and PaO 2 was higher after pre-oxygenation ( MD=54.39, 95% CI 9.32-99.46, P=0.02) in the patients using HFNO than those using facemask ventilation.There were no statistically significant differences in the other outcomes ( P>0.05). Conclusions:HFNO for pre-oxygenation before anesthesia induction can significantly prolong the safe apnea time, increase the lowest SpO 2 during tracheal intubation, and improve the levels of PaO 2 after pre-oxygenation, and HFNO does not affect the patient′s comfort or increase the development of preoxygenation-related complications when compared with facemask ventilation.
