Related Experiment Video
Updated: Sep 17, 2025
Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
Nasal Continuous Positive Airway Pressure to Reduce Hypoxia in Patients With Obesity Undergoing Sedated Upper
Karlo Hünerbein1, Christian Sprenger1, Christian Zöllner1
1Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
Background & Aims:
Patients with obesity are at high risk of hypoxia during sedated upper gastrointestinal (GI) endoscopy, yet no standardized guidelines exist. This study evaluates the effectiveness of nasal continuous positive airway pressure (nCPAP) in reducing hypoxia during the procedure.
Methods:
A prospective, randomized controlled study was conducted on patients with obesity (body mass index ≥30 kg/m2) scheduled for elective sedated upper GI endoscopy with propofol sedation. Patients were randomly assigned to receive either standard oxygen supplementation (nasal cannula [NC]) or nCPAP during the procedure. The primary outcome was the incidence of oxygen desaturation (SpO2 <90%) during endoscopy. Secondary outcomes included the need for airway interventions, procedural success, patient tolerance, and adverse events.
Results:
Of the 158 patients included, there were no significant differences in baseline characteristics between groups (male to female ratio, 71/87; mean age, 51years; mean body mass index, 42.7 kg/m2). The incidence of desaturation was significantly lower in the nCPAP group (7.6%; 95% confidence interval [CI], 1.7%-13.5%) compared with the NC group (25.3%; 95% CI, 15.7%-34.9%; P = .005). Patients in the nCPAP group maintained higher minimum SpO2 levels (97.1% ± 2.0%) than those in the NC group (95.9% ± 2.7%l P = .007). A multivariable logistic regression model identified age (1.06; 95% CI, 1.01-1.11) as an independent risk factor for desaturation, with odds ratio of 5.4 (95% CI, 2.0-16.8) for desaturation events in the NC group compared with the nCPAP group.
Conclusions:
nCPAP significantly reduces hypoxia risk and stabilizes oxygen saturation in patients with obesity undergoing sedated upperHave we correctly interpreted the following funding source(s) and country names you cited in your article: GI, Germany? GI endoscopy, supporting its routine use in these high-risk patients. Further studies should explore its broader clinical application.
Clinicaltrials:
gov, Number: NCT06168682.
Related Concept Videos
01:23Mechanical Ventilation III: Noninvasive Ventilation
Noninvasive Positive-Pressure Ventilation...
01:22Cardiopulmonary Resuscitation II: ACLS Airway Management
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
01:24Endotracheal Tube Extubation
Procedure
Extubation removes the endotracheal tube (ETT) from the patient on mechanical ventilation. It requires a well-coordinated, multidisciplinary approach involving physicians, nurses, respiratory therapists, and other healthcare professionals....
01:19Respiratory Assessment: Purpose and Indications
Objectives and Importance:
The primary goal of respiratory assessment is to evaluate patients at early risk of clinical deterioration. Since respiratory distress often precedes other signs of declining health, breathing patterns and sounds become a...
01:29Administering Oxygen by Nasal Cannula
Nasal Cannulas
A nasal cannula is a lightweight tube split into two prongs placed in the nostrils,...