During colonoscopy, the insertion of the fiberscope and colon distension required to perform the examination may induce modifications to respiratory mechanics, respiratory effort and breathing pattern. High-flow nasal cannula (HFNC) therapy is a mixed air-oxygen supply system able to deliver heated humidified gas up to 60 L/min of flow rate, with an inspiratory oxygen fraction (FiO2) ranging from 21% to 100%. Increasing evidence supports the use of HFNC in several clinical conditions and settings. When compared to standard therapy (ST), HFNC results in enhanced gas exchange and improved comfort. No studies have yet assessed the benefits of HFNC versus ST during and after colonoscopy. The investigators designed this unblinded randomized controlled trial to assess whether HFNC, compared to ST, improves oxygenation at the end of the procedure (primary endpoint). Additional endpoints were: 1) the lowest peripheral saturation of oxygen (SpO2) and the number of oxygen desaturations; 2) the changes of end-expiratory lung impedance and tidal impedance assessed by Electrical Impedance Tomography (EIT); 3) the effects on diaphragm function assessed by ultrasound (DUS).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
36
High Flow Nasal Cannula will be set at 60 liters per minute of air/oxygen admixture to reach a peripheral oxygen saturation equal or greater than 94%
Conventional Oxygen Therapy will be administered through nasal cannula with a oxygen flow set to achieve a peripheral oxygen saturation equal or greater than 94%
AOU Mater Domini
Catanzaro, Italy
Arterial blood gases at end of the procedure
Arterial blood will be sample for gas analysis
Time frame: At the end of the endoscopy
Respiratory effort at end of the procedure
The respiratory effort will be assessed through the ultrasonographic assessment of the diaphragm thickening fraction
Time frame: At the end of the endoscopy
Respiratory effort at baseline
The respiratory effort will be assessed through the ultrasonographic assessment of the diaphragm thickening fraction
Time frame: At enrollment
Respiratory effort at the beginning of the colonoscopy
The respiratory effort will be assessed through the ultrasonographic assessment of the diaphragm thickening fraction
Time frame: At 5 minutes after the beginning of the procedure
Respiratory effort after the colonoscopy
The respiratory effort will be assessed through the ultrasonographic assessment of the diaphragm thickening fraction
Time frame: After 10 minute from the end of the endoscopy
Change of end-expiratory lung impedance (dEELI) from baseline at the beginning of the colonoscopy
change from baseline, expressed in mL, of the end expiratory lung volume as assessed through electrical impedance tomography
Time frame: At 5 minutes after the beginning of the procedure
Change of end-expiratory lung impedance (dEELI) from baseline at end of the procedure
change from baseline, expressed in mL, of the end expiratory lung volume as assessed through electrical impedance tomography
Time frame: At the end of the endoscopy, compared to baseline
Change of end-expiratory lung impedance (dEELI) from baseline after colonoscopy
change from baseline, expressed in mL, of the end expiratory lung volume as assessed through electrical impedance tomography
Time frame: After 10 minute from the end of the endoscopy, compared to baseline
Arterial blood gases at baseline
Arterial blood will be sample for gas analysis
Time frame: At enrollment
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