Background The high-flow nasal cannula (HFNC) is a relatively recent method that provides high-flow, heated, humidified gas delivery. Objectives We compared HFNC (group HF) and conventional nasal cannula (NC) (group CO) during deep sedation with propofol and remifentanil for endoscopic submucosal dissection (ESD). Design Single-center, retrospective observational cohort study. Methods In this study, a total of 159 cases were analyzed (group CO, 71 and group HF, 88). We collected the data from electronic medical records from September 2020 to June 2021. The lowest oxygen saturation (SpO2), incidence of hypoxia (SpO2 < 90%), rescue interventions, and adverse events between the two groups were investigated. Results There were significant differences between the two groups in lowest SpO2 and incidence of hypoxia [group CO versus group HF; 90.3 ± 9.7% versus 95.7 ± 9.0%, 25 (35.2%) versus 10 (11.4%); p < 0.001, p < 0.001; respectively]. Among the rescue interventions, the number of jaw thrust, patient stimulation, O2 flow increase, and nasal airway insertion were significantly higher in the CO group than in the HF group. However, postprocedural chest X-ray showed higher rates of abnormal findings (atelectasis, aspiration, and pneumoperitoneum) in group HF than in group CO [group CO: 8 (11.3%) versus group HF: 26 (29.5%), p = 0.005]. In multivariable analysis, besides group CO, difficult type of lesion was the risk factor for hypoxia. Conclusions Compared to the conventional NC, HFNC provided adequate oxygenation and a stable procedure without significant adverse events during sedation for ESD. However, caution is needed to avoid complications associated with deep sedation and difficult type of lesions.

中文翻译：

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内镜粘膜下剥离术镇静期间高流量鼻插管和传统鼻插管的比较：一项回顾性研究。

背景 高流量鼻插管 (HFNC) 是一种相对较新的方法，可提供高流量、加热、加湿的气体输送。目的 我们比较了使用异丙酚和瑞芬太尼深度镇静进行内镜粘膜下剥离术 (ESD) 期间 HFNC（HF 组）和传统鼻插管（NC）（CO 组）的情况。设计单中心、回顾性观察队列研究。方法本研究共分析159例（CO组71例，HF组88例）。我们收集了2020年9月至2021年6月的电子病历数据。调查两组之间的最低氧饱和度（SpO2）、缺氧发生率（SpO2<90%）、抢救干预措施以及不良事件。结果两组的最低SpO2和缺氧发生率有显着差异[CO组与HF组；90.3 ± 9.7% 对比 95.7 ± 9.0%，25 (35.2%) 对比 10 (11.4%)；p < 0.001，p < 0.001；分别]。在救援干预中，CO 组的下颌推力、患者刺激、O2 流量增加和鼻气道插入的次数显着高于 HF 组。然而，术后胸部 X 光检查显示 HF 组异常现象（肺不张、误吸和气腹）的发生率高于 CO 组 [CO 组：8 (11.3%) 对比 HF 组：26 (29.5%)，p = 0.005 ]。多因素分析显示，除CO组外，疑难病变类型是缺氧的危险因素。结论 与传统 NC 相比，HFNC 在 ESD 镇静期间提供了充足的氧合和稳定的手术过程，没有出现明显的不良事件。然而，需要谨慎避免与深度镇静和困难类型病变相关的并发症。