AUTHOR=Wei Chen , Ma Shaoyong , Jiang Lili , Wang Jingwen , Yuan Liping , Wang Yingying 

TITLE=A meta-analysis of the effects of transnasal high-flow oxygen therapy in gastrointestinal endoscopy

JOURNAL=Frontiers in Medicine

VOLUME=Volume 11 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2024.1419635

DOI=10.3389/fmed.2024.1419635

ISSN=2296-858X

ABSTRACT=The objective of this study was to systematically evaluate the clinical effects of transnasal high flow nasal cannula (HFNC) and conventional oxyge n therapy (COT) in patients undergoing gastrointestinal endoscopy. Methods: A comprehensive literature search was conducted from 2004 to the present to collect relevant studies on the application of high flow nasal cannula in patients undergoing gastrointestinal endoscopy. Multiple Chinese and English databases, including China Knowledge Information Network (CNKI), Wan fang, Web of Science, PubMed, and Cochrane Library, were searched systematically for randomized controlled studies. Two researchers independently screened the literature, extracted data, and assessed the risk of bias in the included studies. Rev Man 5.4 software was utilized for conducting the network meta-analysis. Results: 12 RCTs involving 3726 patients were included. Meta-analysis results showed that high flow nasal cannula reduced the incidence of hypoxemia and i mproved the minimum oxygen saturation (SpO2) when compared with COT, [Odds Ratio (OR)=0.39, 95% CI: (0.29,0.53,)], [mean difference (MD)=4.07, 9 5%CI: (3.14,5.01)], and the difference was statistically significant; however, bas eline SpO2 and incidence of hypercapnia were not statistically different betwee n the high flow nasal cannula and conventional oxygen therapy groups, [MD=-0.21, 95%CI: (-0.49,0.07)], [OR= 1.43, 95% CI: (0.95,2.15)]; in terms of opera tive time, the difference between high flow nasal cannula compared to conventi onal oxygen therapy was not statistically significant, and subgroup analyses wer e performed for the different types of studies, with standard deviation in the g astroscopy group [MD=0.09, 95% CI: (-0.07,0.24)], and endoscopic retrograde c holangiopancreatography group [MD=0.36. 95% CI: (-0.50,1.23)], the analyzed r esults did not differ from the combined results; airway intervention, [OR=0.16, 95% CI: (0.05,0.53)],the difference was statistically significant. Conclusion: High flow nasal cannula has been shown to improve the incidence of hypoxemia, enhance oxygenation, and reduce airway interventions during gastrointestinal endoscopy. However, HFNC did not significantly affect baseline SpO2, hypercapnia, or procedure time. It is important to note the limitations of this study, and further high-quality studies are needed to validate these findings.