Comparison of the efficiency of high flow nasal cannula oxygen and conventional nasal cannula oxygen in pediatric patients under sedation for gastrointestinal endoscopy: A prospective observational study

Background

Oxygenation during upper gastrointestinal (GI) endoscopy in pediatric patients is essential to prevent hypoxia and complications. High-flow nasal cannula oxygenation (HFNO) effectively improves oxygenation compared to conventional nasal cannula oxygenation (NCO). This study compares the efficacy of HFNO and NCO in minimizing hypoxia during sedation.

Methods

This prospective observational study included 82 pediatric patients aged 4–18 years with ASA scores I or II, all undergoing upper GI endoscopy under sedation. Patients received either HFNO or NCO, maintaining SpO2 above 93 %. The primary outcome was hypoxia incidence, while secondary outcomes included hypoxia duration, minimum SpO2 levels, and recovery measures. Statistical significance was set at p < 0.05.

Results

Hypoxia occurred significantly less in the HFNO group (4.9 %) than in the NCO group (22.0 %, p = 0.023). HFNO also led to shorter hypoxia duration and higher minimum SpO2 values (88.5 % vs. 68.4 %, p = 0.034). There were no significant differences in procedure or recovery times, or vomiting rates. The HFNO group maintained better hemodynamic stability, including mean arterial pressure and respiratory rate.

Conclusion

HFNO proved more effective in reducing hypoxia incidence and duration compared to NCO in pediatric patients undergoing upper GI endoscopy. It also enhanced respiratory and hemodynamic stability, indicating its promise as a safer oxygenation method in practice.