The clinical advantage of nasal high-flow in respiratory management during procedural sedation: A scoping review on the application of nasal high-flow during dental procedures with sedation

Kurata, Shinji; Sanuki, Takuro; Higuchi, Hitoshi; Miyawaki, Takuya; Watanabe, Seiji; Miyagawa, Shigeru; Sato, Shuntaro; Pinkham, Max; Tatkov, Stanislav; Ayuse, Takao

doi:10.1016/j.jdsr.2022.05.003

Cited by 3 publications

(3 citation statements)

References 26 publications

(39 reference statements)

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“…For dental treatment given with sedation and for oral and maxillofacial surgery, the treatment site shares part of the upper airway. Therefore, in addition to the risk of upper airway obstruction due to the effects of anaesthesia on neuromuscular functions, mechanical factors, such as mouth opening and neck flexion, may increase the risk of upper airway obstruction [ 30 ]. In response to the aforementioned challenges, pertinent actions have been implemented to enhance the safety of children throughout the perioperative period.…”

Section: Discussionmentioning

confidence: 99%

Bibliometric analysis of pediatric dental sedation research from 1993 to 2022

Zhang,

Zeng,

Zhou

et al. 2024

Heliyon

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Section: Discussionmentioning

confidence: 99%

Bibliometric analysis of pediatric dental sedation research from 1993 to 2022

Zhang,

Zeng,

Zhou

et al. 2024

Heliyon

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“…29 In patients undergoing oral maxillofacial surgery and/or dental treatment, HFNO can maintain oxygenation and possibly prevent hypercapnia. 30 In elderly patients undergoing endoscopic retrograde cholangiopancreatography (ERCP),HFNO may provide adequate oxygenation without causing procedural interruption under deep sedation. 31 During pediatric procedural sedation in congenital heart disease, HFNC could reduce the incidence of desaturation, the need for airway assisted ventilation and risk of carbon dioxide retention without causing hemodynamic instability or gastric distention.…”

Section: Introductionmentioning

confidence: 99%

MostCare-Based Assessment of Cardiac cycle efficiency in Coronary Artery Disease Patients: High-flow nasal cannula versus standard oxygenation for gastrointestinal endoscopy with sedation. The prospective single-center randomised controlled MEHIS study protocol

Xie,

Jin,

et al. 2024

Preprint

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Introduction During gastrointestinal endoscopy (GIE) procedures(upper/lower) performed under deep sedation, patients with coronary artery disease（CAD） have poorer tolerance, with higher incidence of hypotension and myocardial ischemia. Patients with CAD should particularly avoid hypoxemia caused by deep sedation and increased oxygen consumption caused by inadequate sedation. Recent data indicate that high-flow nasal oxygen therapy (HFNO) is recommended for preventing hypoxemia in high-risk patients. The data on cardiac cycle efficiency (CCE) from MostCare can be used to assess myocardial oxygen supply-demand balance in patients with CAD. HFNO may potentially improve myocardial oxygen supply during GIE under deep sedation. We hypothesize that compared to standard oxygen therapy (SOT), HFNO could improve CCE in patients with CAD. Methods and analysis The MEHIS (MostCare-Based Assessment of CCE in CAD Patients：HFNO versus SOT for GIE with sedation. The prospective single-center randomised controlled) study is a single-center randomized controlled trial comparing the effects of HFNO and SOT during GIE under deep sedation administered by anaesthesiologists in the procedure room in patients with CAD. Ninety patients will be randomly allocated in a 1:1 ratio to two parallel groups. The primary outcome is the difference in CCE levels between the two groups during sedation. Secondary outcomes are the incidence of hypotension（hypotension defined as a systolic blood pressure below 80 mmHg）, values of BNP (brain natriuretic peptide), TnI (troponin I), and lactate levels at 6-12 hours post-operation，the occurrence of hypoxemia defined as SpO2 measurement equal to or below 92%, MostCare hemodynamic parameters excluding the primary outcome, interventions required to maintain upper airway patency, patient agitation episodes (assessed by touching the oxygen supply device), and presence of intraoperative adverse memories postoperatively. Keywords high-flow nasal oxygen therapy (HFNO); cardiac cycle efficiency (CCE); gastrointestinal endoscopy (GIE); coronary artery disease（CAD） Trial registration number ChiCTR2400086887 Strengths and limitations of this study 1. This is the first pragmatic randomized single-center study comparing HFNO to SOT for oxygenating patients with CAD undergoing GIE. 2. In contrast to comparing HFNO with high fraction of inspired oxygen (FiO2) typically used in SOT with low oxygen flow and consequently lower FiO2, this study adjusts gas flows to target roughly the same level of applied FiO2 in both groups. This approach aims to assess whether HFNO can improve CCE through positive end-expiratory pressure and/or dead space washout effects. 3. In SOT group, precise FiO2 cannot be guaranteed. That is why we utilized a pre-existing abacus to achieve the best equivalence. 4. Technically, blinding of practitioners and other nursing staff to the study groups is not feasible. However, the printout of recorded primary outcome measures is produced, allowing delayed reading by assessors blinded to treatment allocation. We employed a blind method in the study of patients. 5. In patients not undergoing endotracheal mechanical ventilation, MostCare data collection may exhibit slight bias due to respiratory influences. However, both groups in our study were conducted under sedation, and longitudinal comparisons were performed, thus minimizing the impact of such bias. 6. CAD patients with upper/lower gastrointestinal bleeding often suffer from anemia. We stratified CAD patients into anemic and non-anemic groups and compared the CCE under two oxygen delivery modes. This could provide a basis for further evaluating the oxygen therapy effectiveness of HFNO for anemic patients.

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“…In cases where the upper airways are shared fully or partially like during bronchoscopy, laryngeal surgeries or dental procedures, the use of HFNO has yielded effective oxygenation. [5][6][7][8][9] A systematic review showed that HFNO is effective in reducing the incidence of hypoxaemia, requirement of minor airway manoeuvres and procedure interruptions during sedation. 4 Currently, endobronchial ultrasound (EBUS) and transbronchial sampling have moved from the interventional pulmonology domain to the regular respirology practice.…”

mentioning

confidence: 99%