This study evaluates the ability of high flow nasal cannula versus nasal cannula to oxygenate morbidly obese patients undergoing moderate to deep sedation for gastrointestinal procedures.
The respiratory physiology of morbidly obese patients is altered due to restriction of the chest wall motion which decreases pulmonary compliance. In addition, anatomical changes lead to an increased incidence of airway obstruction in morbidly obese patients during periods of sedation. Both a typical nasal cannula and high flow nasal cannula provide supplemental oxygen to the patients to prevent desaturation and hypoxia. However, the higher flow rates of high flow nasal cannulas are able to produce allows for washout of carbon dioxide from the respiratory system aiding with ventilation and creates 3 to 5 cm H2O of positive end expiration pressure which helps prevent collapse of the airway aiding with oxygenation.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
41
High flow nasal cannula at 50 liters per minute and 50% oxygen will initially be used for oxygenation.
Control group will receive oxygen via standard flow nasal cannula at 5 liters per minute (approximately an FiO2 of 0.35)
Montefiore Medical Center
The Bronx, New York, United States
Ability to Maintain Oxygenation
The ease at which the Anesthesiologist is able to maintain adequate oxygenation during the period of sedation required for the procedure. the ability of each oxygen device to maintain oxygenation was based on the number of manipulations; more manipulations, the device is less effective at maintaining saturation for this population.
Time frame: During the period of sedation, on average up to 1 hour
Number of Participants Requiring Airway Adjuncts During Procedure
The use of airway adjuncts such as oral and nasal airways to insure adequate oxygenation during procedure.
Time frame: During the period of sedation, on average up to 1 hour
Number of Participants Who Need an Increase in Fraction of Inspired Oxygen
Need to increase the FiO2 to maintain adequate oxygenation
Time frame: During period of sedation, on average up to 1 hour
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