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Published on: September 24, 2020
Effects of high-flow nasal oxygen during prolonged deep sedation on postprocedural atelectasis: A randomised
Chung-Chih Shih1, Po-Chin Liang, Yueh-Hsun Chuang
1From the Department of Anaesthesiology (C-CS, Y-HC, Y-JH, P-JL, C-YW) and Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan, ROC (P-CL).
Background:
Atelectasis is common in patients undergoing prolonged deep sedation outside the operating theatre. High-flow nasal oxygen (HFNO) produces positive airway pressure which, hypothetically, should improve lung atelectasis, but this has not been investigated.
Objective:
We investigated whether HFNO ameliorates postprocedural atelectasis and compared the influences of HFNO and facial oxygen by mask on postprocedural outcomes.
Design:
A single-blind, open-label single-institution randomised controlled trial.
Setting:
A single university hospital, from February 2017 to July 2019.
Patients:
A total of 59 patients undergoing computed tomography (CT)-guided hepatic tumour radiofrequency ablation were randomly allocated to two groups.
Intervention:
These patients randomly received HFNO (oxygen flow 10 l min before sedation and 50 l min during the procedure) or a conventional oxygen face mask (oxygen flow 10 l min) during the procedure.
Main Outcome Measures:
Changes in the area of lung atelectasis calculated on the basis of chest CT images and also recovery profiles were compared between the two groups.
Results:
The two groups had comparable procedural profiles, but the HFNO group exhibited less postprocedural atelectasis than the face mask group (median [IQR] 7.4 [3.9 to 11.4%] vs. 10.5 [7.2 to 14.6%]; P = 0.0313). However, the numbers of patients requiring oxygen supplementation in the recovery room and during transport from the recovery room to the ward did not differ significantly between groups (24.1 vs. 50.0%; P = 0.0596).
Conclusion:
Our results suggested that HFNO ameliorates lung atelectasis after prolonged deep sedation in patients receiving CT-guided hepatic tumour radiofrequency ablation.
Trial Registration:
Clinicaltrials.gov Identifier: NCT03019354.
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