Usefulness of High-flow Oxygen Therapy of Patients at Risk of Hypoxemia Undergoing Digestive Endoscopy Under Deep Sedation

Usefulness of High-flow Oxygen Therapy to Improve the Safety of Patients at Risk of Hypoxemia Undergoing Digestive Endoscopy Under Deep Sedation: a Randomized Multicenter Comparative Study

The study investigates the use of high-flow oxygen therapy devices in patients at higher risk of complications during sedated digestive endoscopies. Sedation controlled by the endoscopist improves patient tolerance and facilitates higher-quality procedures, but it can have side effects such as hypoxemia or respiratory depression, especially in patients with sleep apnea, obesity, lung diseases, those over 60 years old, or with a history of sedation complications. While preventive measures, such as oxygen administration, are taken, the study aims to compare the effectiveness of new high-flow oxygen therapy devices with conventional nasal cannulas to improve safety during endoscopies.

Inclusion Criteria:

• Be ≥ 18 years old
• Sign the Informed Consent
• Obesity (BMI ≥ 30 kg/m²)
• ASA III
• Stable pulmonary disease (no hospitalization in the last 6 months)
• Stable heart failure (no hospitalization in the last 6 months)
• Diagnosed or suspected obstructive sleep apnea with a score ≥ 3 on the STOP-Bang scale (APPENDIX II)
• History of sedation-related complications in a previous ESP.

Exclusion Criteria:

• ASA IV patients
• Worsening heart failure at the time of the endoscopy or unstable (hospitalized < 6 months)
• Worsening respiratory disease at the time of the endoscopy or unstable (hospitalized < 6 months)
• Pregnant women
• Use of home oxygen therapy
• Patients with orotracheal intubation
• Tracheostomized patients
• Patients allergic to or unable to use propofol