Noninvasive Ventilation During Endoscopic Procedures: Rationale, Clinical Use, and Devices

Area of Science:

• Medical procedures
• Respiratory support
• Anesthesiology

Background:

• Endoscopic procedures (e.g., transesophageal echocardiography, gastroscopy, airway fibroscopy) are common but can lead to respiratory compromise in sedated patients.
• Hypoxia and respiratory failure during endoscopy may necessitate procedure termination.
• General anesthesia is often used but carries risks and increases costs.

Purpose of the Study:

• To evaluate the use of periprocedural noninvasive ventilation (NIV) during endoscopic procedures.
• To assess the feasibility and benefits of novel NIV masks designed for endoscopic access.
• To explore NIV as an alternative to general anesthesia in specific endoscopic interventions.

Main Methods:

• Utilized specialized noninvasive ventilation masks that accommodate endoscopic probes.
• Administered ventilatory support during various endoscopic procedures, including transesophageal cardiac examinations and bronchoscopies.
• Applied in diverse settings such as operating rooms and intensive care units.

Main Results:

• Positive preliminary results reported across different clinical contexts.
• Successful delivery of ventilatory support during complex endoscopic interventions.
• Enabled some procedures under sedation with NIV, avoiding general anesthesia.

Conclusions:

• Periprocedural NIV is a viable strategy to improve oxygenation during endoscopic procedures.
• Innovative NIV devices facilitate endoscopic interventions under sedation, potentially replacing general anesthesia.
• These approaches may lead to reduced costs, fewer organizational demands, and decreased complications.