Nasal Continuous Positive Airway Pressure to Reduce Hypoxia in Patients With Obesity Undergoing Sedated Upper Gastrointestinal Endoscopy: A Prospective Randomized Trial.

IF 12 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Clinical Gastroenterology and Hepatology Pub Date : 2025-07-01 DOI:10.1016/j.cgh.2025.06.015

Karlo Hünerbein, Christian Sprenger, Christian Zöllner, Jocelyn de Heer, Moritz von Wulffen, Katharina Zimmermann, Thomas Rösch, Malte Issleib

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引用次数: 0

Abstract

Background & aims: Patients with obesity are at high risk of hypoxia during sedated upper gastrointestinal (GI) endoscopy, yet no standardized guidelines exist. This study evaluates the effectiveness of nasal continuous positive airway pressure (nCPAP) in reducing hypoxia during the procedure.

Methods: A prospective, randomized controlled study was conducted on patients with obesity (body mass index ≥30 kg/m²) scheduled for elective sedated upper GI endoscopy with propofol sedation. Patients were randomly assigned to receive either standard oxygen supplementation (nasal cannula [NC]) or nCPAP during the procedure. The primary outcome was the incidence of oxygen desaturation (SpO₂ <90%) during endoscopy. Secondary outcomes included the need for airway interventions, procedural success, patient tolerance, and adverse events.

Results: Of the 158 patients included, there were no significant differences in baseline characteristics between groups (male to female ratio, 71/87; mean age, 51years; mean body mass index, 42.7 kg/m²). The incidence of desaturation was significantly lower in the nCPAP group (7.6%; 95% confidence interval [CI], 1.7%-13.5%) compared with the NC group (25.3%; 95% CI, 15.7%-34.9%; P = .005). Patients in the nCPAP group maintained higher minimum SpO₂ levels (97.1% ± 2.0%) than those in the NC group (95.9% ± 2.7%l P = .007). A multivariable logistic regression model identified age (1.06; 95% CI, 1.01-1.11) as an independent risk factor for desaturation, with odds ratio of 5.4 (95% CI, 2.0-16.8) for desaturation events in the NC group compared with the nCPAP group.

Conclusion: nCPAP significantly reduces hypoxia risk and stabilizes oxygen saturation in patients with obesity undergoing sedated upperHave we correctly interpreted the following funding source(s) and country names you cited in your article: GI, Germany? GI endoscopy, supporting its routine use in these high-risk patients. Further studies should explore its broader clinical application.

Clinicaltrials: gov, Number: NCT06168682.

查看原文本刊更多论文

鼻CPAP减少肥胖患者接受镇静上消化道内镜检查时的缺氧：一项前瞻性随机试验。

背景与目的：肥胖患者在镇静的上消化道内镜检查中存在缺氧的高风险，但目前尚无标准化的指导方针。本研究评估鼻持续气道正压通气（nCPAP）在手术过程中减少缺氧的有效性。方法：采用前瞻性、随机对照研究，对肥胖患者（BMI≥30 kg/m2）进行选择性镇静上消化道内窥镜检查并应用异丙酚镇静。在手术过程中，患者被随机分配接受标准氧补充（鼻插管，NC）或nCPAP。结果：在纳入的158例患者中，两组间基线特征无显著差异(m:f=71/87；平均年龄51岁；平均BMI为42.7 kg/m2)。nCPAP组去饱和发生率显著降低(7.6%；95% CI[1.7% - 13.5%])与NC组(25.3%；95% CI [15.7% ~ 34.9%], p=0.005)。nCPAP组患者SpO2最低水平（97.1%±2.0）高于NC组（95.9%±2.7,p=0.007）。多变量logistic回归模型识别出年龄(1.06；95% CI[1.01 - 1.11])作为去饱和的独立危险因素，与nCPAP组相比，NC组的去饱和事件OR为5.4 （95% CI[2.0 - 16.8]）。结论：nCPAP可显著降低接受镇静上消化道内镜检查的肥胖患者的缺氧风险并稳定氧饱和度，支持在这些高危患者中常规应用。进一步的研究应探索其更广泛的临床应用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Gastroenterology and Hepatology 医学-胃肠肝病学

CiteScore

16.90

自引率

4.80%

发文量

903

审稿时长

22 days

期刊介绍： Clinical Gastroenterology and Hepatology (CGH) is dedicated to offering readers a comprehensive exploration of themes in clinical gastroenterology and hepatology. Encompassing diagnostic, endoscopic, interventional, and therapeutic advances, the journal covers areas such as cancer, inflammatory diseases, functional gastrointestinal disorders, nutrition, absorption, and secretion. As a peer-reviewed publication, CGH features original articles and scholarly reviews, ensuring immediate relevance to the practice of gastroenterology and hepatology. Beyond peer-reviewed content, the journal includes invited key reviews and articles on endoscopy/practice-based technology, health-care policy, and practice management. Multimedia elements, including images, video abstracts, and podcasts, enhance the reader's experience. CGH remains actively engaged with its audience through updates and commentary shared via platforms such as Facebook and Twitter.