Stop questionnaire to screen for hypoxemia in deep sedation for young and middle‐aged colonoscopy

Deng, Li; Li, Chenglong; Ge, Shengxiang; Fang, Yan; Ji, Fuhai; Yang, Jianping

doi:10.1111/j.1443-1661.2011.01217.x

Cited by 6 publications

(3 citation statements)

References 25 publications

(25 reference statements)

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“…The primary endpoint was the area under the curve of 90% oxygen desaturation (AUC Desat ) [26, 27]. The AUC Desat was defined as the integrated area under oxygen saturation (SpO 2 ) for a selected cut point per 10 seconds.…”

Section: Methodsmentioning

confidence: 99%

High-Flow Nasal Cannula and Mandibular Advancement Bite Block Decrease Hypoxic Events during Sedative Esophagogastroduodenoscopy: A Randomized Clinical Trial

Teng

Ting

Wang

et al. 2019

BioMed Research International

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During sedated endoscopic examinations, upper airway obstruction occurs. Nasal breathing often shifts to oral breathing during open mouth esophagogastroduodenoscopy (EGD). High-flow nasal cannula (HFNC) which delivers humidified 100% oxygen at 30 L min−1 may prevent hypoxemia. A mandibular advancement (MA) bite block with oxygen inlet directed to both mouth and nose may prevent airway obstruction during sedated EGD. The purpose of this study was to evaluate the efficacy of these airway devices versus standard management. One hundred and eighty-nine patients were assessed for eligibility. One hundred and fifty-three were enrolled. This study randomly assigned eligible patients to three arms: the standard bite block and standard nasal cannula, HFNC, and MA bite block groups. EGD was performed after anaesthetic induction. The primary endpoint was the oxygen desaturation area under curve at 90% (AUCDesat). The secondary endpoints were percentage of patients with hypoxic, upper airway obstruction, and apnoeic and rescue events. One hundred and fifty-three patients were enrolled. AUCdesat was significantly lower for HFNC and MA bite blocks versus the standard management (p= 0.019). The HFNC reduced hypoxic events by 18% despite similar airway obstruction and apnoeic events as standard group. The MA bite block reduced hypoxic events by 12% and airway obstructions by 32%. The HFNC and MA groups both showed a 16% and 14% reduction in the number of patients who received rescue intervention, respectively, compared to the standard group. The HFNC and MA bite block may both reduce degree and duration of hypoxemia. HFNC may decrease hypoxemic events while maintaining nasal patency is crucial during sedative EGD. The MA bite block may prevent airway obstruction and decrease the need for rescue intervention.

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Section: Methodsmentioning

confidence: 99%

High-Flow Nasal Cannula and Mandibular Advancement Bite Block Decrease Hypoxic Events during Sedative Esophagogastroduodenoscopy: A Randomized Clinical Trial

Teng

Ting

Wang

et al. 2019

BioMed Research International

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“…Hypoxemia has been shown to trigger myocardial ischemia during endoscopy in individuals with and without previous cardiac history and can eventually lead to neurological damage and death [21,22,23]. Due to the intuitive and straight relation between hypoxemia and adverse events as well as the rarity of severe complications during endoscopy, hypoxemia has been used as a surrogate for main periprocedural cardiopulmonary events [24,25]. …”

Section: Introductionmentioning

confidence: 99%

Propofol versus Midazolam in Medical Thoracoscopy: A Randomized, Noninferiority Trial

Grendelmeier

Tamm²,

Jahn

et al. 2014

Respiration

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Background: Hypoxemia is a surrogate marker for periprocedural endoscopic complications. There are no data comparing the safety of propofol sedation with another sedative regimen in medical thoracoscopy. Objective: To evaluate whether sedation with propofol is as safe and effective as sedation with midazolam. Methods: Ninety consecutive patients undergoing medical thoracoscopy were randomly allocated to receive either intravenous propofol or midazolam. Predefined periprocedural complications included hypoxemia, hypotension, bleeding, need for airway insertion, mechanical ventilation, intensive care unit transfer and death. The primary endpoint was the mean lowest oxygen saturation during the procedure. Results: Randomized groups had similar demographics (64 ± 16 years, 57% male, 91% American Society of Anesthesiologists class III-IV) and a balanced distribution of procedures. The mean lowest oxygen saturation during the procedure was significantly lower in the propofol group as compared to the midazolam group (93 ± 6 vs. 96 ± 3%, p = 0.007). Patients randomized to propofol showed more episodes of hypoxemia (27 vs. 4%, p = 0.007) and hypotension (82 vs. 40%, p < 0.0001). No procedure had to be aborted. None of the patients required an artificial airway, mechanical ventilation or intensive care unit care, and none died. Conclusions: As assessed by the surrogate marker hypoxemia, propofol should not be considered the first choice for sedation in medical thoracoscopy.

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“…The study was conducted under a protocol approved by the Nanjing First Hospital ethics committee and the requirement for informed consent was waived (grant number: KY20220509-01-KS-01). The inclusion criteria for this study were as follows: age of ≥ 18 and < 65, 15 and American Society of Anesthesiologists (ASA) class I–III; while the exclusion criteria as follows: baseline pulse oximeter oxygen saturation (SpO 2 ) < 95%, hemoglobin < 100 g/L, pregnancy, upper respiratory tract infection, significant cardiopulmonary diseases such as acute myocardial infarction, heart and respiratory failure, and without availability of complete clinical information.…”

Section: Methodsmentioning

confidence: 99%

An interpretable artificial neural network model for predicting hypoxemia via an online tool in adult (18–64) patients during esophagogastroduodenoscopy

et al. 2023

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Background The hypoxemia risk in adult (18–64) patients treated with esophagogastroduodenoscopy (EGD) under sedation often poses a dilemma for anesthesiologists. We aimed to establish an artificial neural network (ANN) model to solve this problem, and introduce the Shapley additive explanations (SHAP) algorithm to further improve the interpretability. Methods The relevant data of patients underwent routine anesthesia-assisted EGD were collected. Elastic network was used to filter the optimal features. Airway-ANN and Basic-ANN models were established based on all collected indicators and remaining variables excluding airway assessment indicators, respectively. The performance of Basic-ANN, Airway-ANN and STOP-BANG was evaluated by the area under the precision-recall curve (AUPRC) on temporal validation set. The SHAP was used for revealing the predictive behavior of our best model. Results 999 patients were eventually included. The AUPRC value of Airway-ANN model was significantly higher than Basic-ANN model in the temporal validation set (0.532 vs 0.429, P < 0.05). And the performance of both two ANN models was significantly better than that of STOP-BANG score (both P < 0.05). The Airway-ANN model was deployed to the cloud ( http://njfh-yxb.com.cn:2022/airway_ann ). Conclusion Our online interpretable Airway-ANN model achieved satisfying ability in identifying the hypoxemia risk in adult (18–64) patients undergoing EGD.

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Stop questionnaire to screen for hypoxemia in deep sedation for young and middle‐aged colonoscopy

Abstract: STOP Questionnaire is a validated and easy-to-use screening tool for hypoxemia in outpatient colonoscopy. It has high sensitivity, specificity and negative predictive value.

Cited by 6 publications

References 25 publications

High-Flow Nasal Cannula and Mandibular Advancement Bite Block Decrease Hypoxic Events during Sedative Esophagogastroduodenoscopy: A Randomized Clinical Trial

High-Flow Nasal Cannula and Mandibular Advancement Bite Block Decrease Hypoxic Events during Sedative Esophagogastroduodenoscopy: A Randomized Clinical Trial

Propofol versus Midazolam in Medical Thoracoscopy: A Randomized, Noninferiority Trial

An interpretable artificial neural network model for predicting hypoxemia via an online tool in adult (18–64) patients during esophagogastroduodenoscopy

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