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Carbon Dioxide vs. Air Insufflation for Pediatric Gastrointestinal Endoscopy: A Systematic Review and Meta-Analysis

Chunwang Ji1, Xue Liu2, Peng Huang3

  • 1Grade 2017, Queen Mary Institute, Nanchang University, Nanchang, China.

Frontiers in Pediatrics
|February 26, 2021
PubMed

Insights

Carbon dioxide (CO2) insufflation may reduce pain and bloating in pediatric gastrointestinal endoscopies compared to air. However, more high-quality trials are needed to confirm its routine use in pediatric gastroenterology.

Area of Science:

  • Pediatric Gastroenterology
  • Endoscopic Procedures

Background:

  • Carbon dioxide (CO2) insufflation is popular in adult GI endoscopies, but its use in pediatric patients is not well-established.
  • This review compares the efficacy of CO2 versus air insufflation for pediatric GI endoscopic procedures.

Approach:

  • A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted.
  • Searched PubMed, Embase, Scopus, and CENTRAL databases up to August 15, 2020.
  • Included five RCTs involving 226 patients in the CO2 group and 224 in the air group.

Key Points:

  • CO2 insufflation was associated with lower odds of postoperative pain (OR: 0.40; 95% CI: 0.19, 0.87; p=0.02).
  • No significant difference in abdominal distention was observed between CO2 and air groups.
  • Bloating was significantly reduced in the CO2 group, with no reported pulmonary complications despite transient CO2 elevation.

Conclusions:

  • CO2 insufflation appears to reduce pain and bloating in pediatric GI endoscopies without significant adverse events.
  • Current evidence is limited, necessitating further high-quality RCTs before routine adoption in pediatric practice.

Keywords:
Carbon dioxidechildrencolonoscopyendoscopygastrointestinal pain

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