Chronic Obstructive Pulmonary Disease (COPD), Esophageal Cancer, Gastric Cancer (Diagnosis), Hypoxemia
Conditions
Keywords
high-flow nasal cannula, Hypoxemia, Chronic Obstructive Pulmonary Disease, Sedation, Gastrointestinal Endoscopy
Brief summary
Hypoxemia is the most common adverse event during propofol sedation for gastrointestinal endoscopy in patients with chronic obstructive pulmonary disease (COPD) due to diminished pulmonary reserve. Although high-flow nasal cannula (HFNC) oxygenation has been shown to effectively reduce hypoxemia during sedated endoscopy in obese patients, its application in COPD patients remains an evidence gap, largely owing to the traditional concern that high-concentration oxygen may suppress respiratory drive and exacerbate CO₂ retention. This study aims to investigate whether HFNC can reduce the incidence of hypoxemia during sedated gastrointestinal endoscopy in patients with COPD.
Interventions
DEVICEHigh-flow nasal cannula
Using high-flow nasal cannula oxygenation
Sponsors
Zhejiang University
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age ≥18 years; * Confirmed diagnosis of chronic obstructive pulmonary disease (COPD); * Scheduled for elective sedated gastroenteroscopy (gastroscopy, colonoscopy, or combined gastroscopy and colonoscopy); * Expected procedure duration ≤45 minutes; * Provision of written informed consent by the participant.
Exclusion criteria
* Patients with absolute contraindications to high-flow therapy, including but not limited to confirmed diagnosis of complete upper airway obstruction, basilar skull fracture or nasal bone fracture, pneumothorax, or pneumomediastinum.; * American Society of Anesthesiologists (ASA) Physical Status class ≥ IV; * Requirement for planned endotracheal intubation; * Existing tracheostomy; * Confirmed pregnancy or currently breastfeeding; * Known allergy to sedative agents such as propofol; * Current participation in another interventional clinical trial; * Any other condition deemed by the investigator to make the patient unsuitable for trial participation.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The incidence of hypoxemia | Patients will be followed for the duration of hospital stay, an expected average about 2 hours | 75% ≤ SpO2 \< 90% for \<60 s |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The incidence of sub-clinical respiratory depression | Patients will be followed for the duration of hospital stay, an expected average about 2 hours | 90% ≤ SpO2 \< 95% |
| The incidence of severe hypoxemia | Patients will be followed for the duration of hospital stay, an expected average about 2 hours | SpO2 \< 75% or 75% ≤ SpO2 \< 90% for ≥60 s |
| The incidence of other adverse events | Patients will be followed for the duration of hospital stay, an expected average about 2 hours | Other adverse events recorded by tools proposed by the World Society of Intravenous Anesthesia International Sedation Task Force |
Countries
China
Contacts
CONTACTDiansan Su
CONTACTMingxia Xu
Outcome results
None listed