Анестезия и клинические исследования
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ISSN: 2155-6148
ISSN: 2155-6148
Kavitha Shetty*, Jonathan Chua, Alfonse Nguyen, Ashwani Kumar, Vanessa Wilkinson
Background: The clinical applications of High Flow Nasal Cannula (HFNC) are well established in the operating theatres.
Objective: The objective was to study the impact of using HFNC in a Non-Operating Room Anesthetic (NORA) setting.
Methods: This was a retrospective and prospective observational study looking at two periods (6 months and 5 months respectively in 2017 and 2018) in time-pre and post introduction of HFNC into clinical practice in sedation for gastroscopies, colonoscopies, Trans Oesophageal Echocardiograpies (TOE) and Bronchoscopies. The use of HFNC in NORA setting when introduced in 2018 was studied for a period of 5 months. Primary outcomes studied were Hypoxia during the procedure and secondary outcome was length of stay in the hospital post procedure.
Results: 98 versus 110 consecutive patients undergoing procedural sedation in NORA prior to and after the introduction of HFNC were studied. We found that the mean BMI was significantly higher in the post- HFNC group. They also had a higher incidence of comorbidities and difficult airway. Patients in the pre- HFNC group had a statistically significant lower mean lowest saturation recorded during the procedure. Patients in the post HFNC group had a shorter recovery time.
Conclusion: Previous studies have shown the benefits of HFNC in various pre and intraoperative settings. However, our study specifically targeted the role of HFNC in NORA setting. We found that HFNP makes procedural sedation a lot safer, shorter, more comfortable, and allows a wider spectrum of high-risk patients to have the procedure in the NORA setting.