Study on the Safety of High-flow Nasal Oxygen Therapy With Different Flow Rates in Obese Patients Undergoing Sedative Gastroscopy

Status: Recruiting
Location: See location...
Intervention Type: Behavioral
Study Type: Interventional
Study Phase: Not Applicable
SUMMARY

Obese patients often have fat accumulation in the head and neck, increased soft tissue in the oropharynx, decreased lung compliance, decreased lung volume and residual volume, and some obese patients also suffer from obstructive sleep apnea. Therefore, obese patients may experience hypoxemia during sedative gastroscopy. High-flow nasal cannula oxygen therapy (HFNC) can provide patients with high-flow (20-70 L/min) and adjustable oxygen concentration (21%-100%) through a special nasal prong catheter. It has the function of warming and humidifying the air, relieving pressure on the nasal mucosa, maintaining airway patency and moisture, reducing the risk of nasal bleeding. In addition, HFNC can generate positive airway pressure (3-7 cmH2O), increase end-expiratory volume, help with alveolar recruitment, prevent atelectasis, and reduce shunts. The flow rate of HFNC is positively correlated with the nasopharyngeal pressure. At a flow rate of 50 L/min, the nasopharyngeal pressure can exceed 3 cmH2O. Obese patients are prone to upper airway obstruction under sedation or anesthesia. The use of HFNC at 70 L/min perioperatively can reduce hypoxemia in patients, but discomfort in the nasopharynx may occur at this flow rate. The optimal flow rate for clinical use of HFNC has not been established. Meta-analysis shows that when the oxygen flow rate during painless esophagogastroduodenoscopy is greater than 30 L/min, it can significantly reduce the incidence of hypoxemia in patients. Therefore, for obese patients undergoing painless esophagogastroduodenoscopy, the investigators propose using HFNC at three different flow rates: 30 L/min, 50 L/min, and 70 L/min, to provide guidance on the optimal flow rate for clinical use of HFNC.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 18
Healthy Volunteers: f
View:

• Patients undergoing sedative gastroscopy

• Aged over 18.

• ASA classification I-III

• Interincisal distance \>6.5cm, no micrognathia, limited mouth opening and limited cervical spine movement

• Compliance with ethics, patient willing to participate in the trial, signed informed consent form

Locations
Other Locations
China
Nanjing First Hospital
RECRUITING
Nanjing
Contact Information
Primary
Jing Hu
hujingmz@163.com
15366110201
Time Frame
Start Date: 2024-10-23
Estimated Completion Date: 2025-10-20
Participants
Target number of participants: 864
Treatments
Experimental: HFNC30L/min
patients pre-oxygenation with pure oxygen at 30L/min for 1 minute, followed by sedation with slightly slow but steady breathing, disappearance of eyelash reflex, and continued oxygen flow at 30 L/min
Experimental: HFNC50L/min
patients pre-oxygenation with pure oxygen at 30L/min for 1 minute, followed by sedation with slightly slow but steady breathing, adjustment of oxygen flow to 50L/min after disappearance of eyelash reflex.
Experimental: HFNC70L/min
patients pre-oxygenation with pure oxygen at 30L/min for 1 minute, followed by sedation with slightly slow but steady breathing, adjustment of oxygen flow to 70L/min after disappearance of eyelash reflex.
Sponsors
Leads: XiaoLiang Wang

This content was sourced from clinicaltrials.gov