ORIGINAL RESEARCH article
Front. Med.
Sec. Intensive Care Medicine and Anesthesiology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1517819
This article is part of the Research TopicMajor Complications in Interventional Oncology ProceduresView all 3 articles
High-Flow Nasal Cannula Oxygenation Reduces Desaturation During Percutaneous Radiofrequency Ablation Under Moderate Sedation
Provisionally accepted
- 1Department of Anesthesiology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Jiangsu Province, China
- 2Department of Anesthesiology, Zhejiang Cancer Hospital, Hangzhou, Jiangsu Province, China
- 3First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
- 4Department of Thyroid Surgery, Zhejiang Cancer Hospital, Hangzhou, China
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Background: Most liver cancer percutaneous radiofrequency ablation (PRFA) procedures are performed under ultrasound guidance with moderate sedation. Oxygen desaturation is one of the most common and most concerning adverse events and is difficult to avoid during this procedure. High-flow nasal cannula (HFNC) oxygen therapy is capable of delivering high oxygen flow rates. This study aimed to evaluate the safety of HFNC oxygen therapy for preventing oxygen desaturation in patients undergoing ultrasound-guided PRFA with moderate sedation.In this prospective, randomized controlled study, 100 patients who underwent ultrasoundguided PRFA with moderate sedation were randomly divided into two groups: the lower-flow oxygen group (6 L/minute via HFNC) and the higher-flow oxygen group (40 L/minute via HFNC). The primary outcome was oxygen desaturation. Other adverse events were also recorded.Results: Patients receiving higher-flow oxygen (40 L/min) had a lower incidence of mild desaturation (0% vs. 6%, P=0.24), moderate desaturation (4% vs. 30%; RR 7.5, 95% CI 2.07, 28.58, P=0.0009), and severe desaturation (0% vs. 4%, P=0.5) compared to those receiving lower-flow oxygen (6 L/min).Average oxygen saturation (SpO2) was significantly higher in the higher-flow group (P<0.0001). No significant differences were observed in other adverse events or perioperative variables.In patients undergoing ultrasound-guided PRFA with moderate sedation, higher-flow oxygen therapy at 40 L/min via HFNC, compared to 6 L/min, was associated with a higher average oxygen saturation and a reduced incidence of oxygen desaturation, particularly moderate and severe desaturation.
Keywords: High-Flow Nasal Cannula Oxygenation Reduces Desaturation During Percutaneous Radiofrequency Ablation Under Moderate Sedation High-Flow Nasal Cannula Oxygenation Decrease Desaturation In Moderate Sedation HFNC, desaturation, liver cancer, PrfA, Moderate Sedation HFNC, sedation, Oxygen saturation Clinical trial registration. NCT05212064
Received: 27 Oct 2024; Accepted: 24 Jun 2025.
Copyright: © 2025 Wang, Wu, Ding, Zhang, Xie, Mao and Fang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xiangming Fang, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310016, Zhejiang Province, China
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