Observational study compares hypoxia incidences in sedation during endoscopy, suggesting HFNC may be better.
Introduction: Hypoxia is a common complication during upper gastrointestinal endoscopyunder deep sedation. While simple nasal cannulas are commonly used for oxygen delivery, high-flow nasal cannulas (HFNC) provide higher oxygen levels, generate positive pressure, and reduce dead space. We hypothesize that HFNC reduces the risk of hypoxia compared to simple nasal cannulas in these procedures. Methods: This was prospective, comparative observational study conducted in a tertiary care center of Nepal with the primary objective to compare the rates of hypoxia (SpO2 < 92%) and secondary objectives were to compare interruption of procedure due to hypoxia, the lowest oxygen level recorded and episodes of hypoxia between high flow nasal cannula (flow rate of 30l/min with FiO2 of 0.5) and simple nasal cannula (flow rate of 6l/min) in patients undergoing upper gastrointestinal endoscopic procedures in deep sedation using propofol infusion. Results: A total of 112 patients were enrolled, with 56 receiving oxygen via simple nasal cannula (SNC) and 56 via high-flow nasal cannula. Hypoxia occurred significantly more in the SNC group compared to the HFNC group (37.50% vs. 16.07%, p=0.01). Severehypoxia was also more frequent with SNC (16.07% vs. 5.36%). Multiple hypoxia episodes were observed only in the SNC group (8.93% vs. 0%). Procedure abandonment was higher in the SNC group (7.14% vs. 1.79%). Conclusion: The use of high flow nasal cannula reduces the incidence of hypoxia in patients undergoing upper gastrointestinal endoscopic procedures with deep sedation compared to simple nasal cannula.
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Karki et al. (2026) studied this question.