High flow nasal oxygen during procedural sedation for cardiac implantable electronic device procedures: A randomised controlled trial
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Description
BACKGROUND High flow nasal oxygen may better support the vulnerable respiratory state of patients during procedural sedation.
OBJECTIVE The objective of this study was to investigate the effects of high flow nasal oxygen in comparison to facemask oxygen on ventilation during cardiac implantable electronic device procedures performed with procedural sedation.
DESIGN A randomised controlled trial.
SETTING The study was conducted at one academic hospital in Canada.
PARTICIPANTS Adults undergoing elective cardiac implantable electronic device procedures with sedation administered by an anaesthesia assistant, supervised by an anaesthesiologist from August 2019 to March 2020.
INTERVENTIONS Participants were randomised 1 : 1 to facemask (≥ 8 l · min-1) or high flow nasal oxygen (50 l · min-1 and a 50 : 50 oxygen to air ratio).
MAIN OUTCOME MEASURES The primary outcome was peak transcutaneous carbon dioxide. Outcomes were analysed using Bayesian statistics.
RESULTS The 129 participants who were randomised and received sedation were included. The difference in peak transcutaneous carbon dioxide was 0.0 kPa (95% CI -0.17 to 0.18). Minor adverse sedation events were 6.4 times more likely to occur in the high flow nasal oxygen group. This estimate is imprecise (95% CI 1.34 to 42.99). The odds ratio for oxygen desaturation for the high flow nasal oxygen group compared with the facemask group was 1.2 (95% CI 0.37 to 3.75). The difference in satisfaction with sedation scores between groups was 0.0 (95% CI -0.33 to 0.23).
CONCLUSIONS Ventilation, as measured by TcCO2, is highly unlikely to differ by a clinically important amount between high flow nasal oxygen at 50 l min-1 or facemask oxygen at 8 l min-1. Further research with a larger sample size would be required to determine the optimal oxygen:air ratio when using high flow nasal oxygen during cardiac implantable electronic device procedures performed with sedation.
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| ID Code: | 242564 |
|---|---|
| Item Type: | Contribution to Journal (Journal Article) |
| Refereed: | Yes |
| Additional Information: | Funding Information: Financial support and sponsorship: this study was funded by a Connaught New Researcher Award (University of Toronto). MP is supported by an Early Investigator Merit Award from the Department of Anesthesia, University of Toronto and Toronto General Hospital. |
| Measurements or Duration: | 11 pages |
| DOI: | 10.1097/EJA.0000000000001458 |
| ISSN: | 0265-0215 |
| Pure ID: | 143794893 |
| Divisions: | Current > QUT Faculties and Divisions > Faculty of Health Current > Schools > School of Nursing |
| Funding Information: | Financial support and sponsorship: this study was funded by a Connaught New Researcher Award (University of Toronto). MP is supported by an Early Investigator Merit Award from the Department of Anesthesia, University of Toronto and Toronto General Hospital. |
| Copyright Owner: | 2021 European Society of Anaesthesiology and Intensive Care. |
| Copyright Statement: | This work is covered by copyright. Unless the document is being made available under a Creative Commons Licence, you must assume that re-use is limited to personal use and that permission from the copyright owner must be obtained for all other uses. If the document is available under a Creative Commons License (or other specified license) then refer to the Licence for details of permitted re-use. It is a condition of access that users recognise and abide by the legal requirements associated with these rights. If you believe that this work infringes copyright please provide details by email to qut.copyright@qut.edu.au |
| Deposited On: | 06 Sep 2023 03:11 |
| Last Modified: | 12 Jul 2024 09:28 |
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