High flow nasal oxygen during procedural sedation for cardiac implantable electronic device procedures: A randomised controlled trial.
Eur J Anaesthesiol
; 38(8): 839-849, 2021 08 01.
Article
en En
| MEDLINE
| ID: mdl-33492872
ABSTRACT
BACKGROUND:
High flow nasal oxygen may better support the vulnerable respiratory state of patients during procedural sedation.OBJECTIVE:
The objective of this study was to investigate the effects of high flow nasal oxygen in comparison to facemask oxygen on ventilation during cardiac implantable electronic device procedures performed with procedural sedation.DESIGN:
A randomised controlled trial.SETTING:
The study was conducted at one academic hospital in Canada.PARTICIPANTS:
Adults undergoing elective cardiac implantable electronic device procedures with sedation administered by an anaesthesia assistant, supervised by an anaesthesiologist from August 2019 to March 2020.INTERVENTIONS:
Participants were randomised 1ââ1 to facemask (≥ 8âlâ·âmin-1) or high flow nasal oxygen (50âlâ·âmin-1 and a 50ââ50 oxygen to air ratio). MAIN OUTCOMEMEASURES:
The primary outcome was peak transcutaneous carbon dioxide. Outcomes were analysed using Bayesian statistics.RESULTS:
The 129 participants who were randomised and received sedation were included. The difference in peak transcutaneous carbon dioxide was 0.0âkPa (95% CI -0.17 to 0.18). Minor adverse sedation events were 6.4 times more likely to occur in the high flow nasal oxygen group. This estimate is imprecise (95% CI 1.34 to 42.99). The odds ratio for oxygen desaturation for the high flow nasal oxygen group compared with the facemask group was 1.2 (95% CI 0.37 to 3.75). The difference in satisfaction with sedation scores between groups was 0.0 (95% CI -0.33 to 0.23).CONCLUSIONS:
Ventilation, as measured by TcCO2, is highly unlikely to differ by a clinically important amount between high flow nasal oxygen at 50âlâmin-1 or facemask oxygen at 8âlâmin-1. Further research with a larger sample size would be required to determine the optimal oxygenair ratio when using high flow nasal oxygen during cardiac implantable electronic device procedures performed with sedation. TRIAL REGISTRATION NUMBER NCT03858257.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Oxígeno
/
Máscaras
Tipo de estudio:
Clinical_trials
/
Prognostic_studies
Límite:
Adult
/
Humans
País/Región como asunto:
America do norte
Idioma:
En
Año:
2021
Tipo del documento:
Article