Efficacy of high-flow nasal oxygen during drug-induced sleep endoscopy in patients with obstructive sleep apnea

High-flow nasal oxygenation (HFNO) can provide a low level of continuous positive airway pressure and alveolar recruitment. We aimed to compare the efficacy of pre-oxygenation with HFNO and low-flow nasal oxygenation (LFNO) during drug-induced sleep endoscopy (DISE).

In the LFNO group, preoxygenation was performed for 10 min at 3 L·min^-1. In the HFNO group, preoxygenation was performed for 10 min at 30 L·min^-1 at a fraction of inspired oxygen of 100% using the Optiflow device. From the start of sedative administration to the end of DISE, vital signs were monitored continuously. The primary outcome was the lowest oxygen saturation (SpO₂) during DISE.

Of 24 patients enrolled, 12 were randomly assigned to the LFNO and 12 to the HFNO groups. The prevalence of hypoxia events was 75% in the LFNO group and 58% in the HFNO group. The difference in lowest oxygen saturation between the two groups was not significant between the two groups (P=0.665). The lowest SpO₂ during all procedures was comparable between the two groups (86.8 ± 6.5% in the LFNO group and 87.2 ± 8.0% in the HFNO group; P=0.912).

The findings suggest that HFNO may not be superior to LFNO as a preoxygenation tool to prevent hypoxia during DISE.