Use of High Flow Nasal Cannula During Sedation of Morbidly Obese Patients in the Endoscopy Suite

Montefiore Medicine Academic Health System

Status: Completed

Conditions: Noninvasive Ventilation; Deep Sedation; Morbid Obesity

Treatments: Device: High flow nasal cannula; Device: Nasal Cannula

Study type: Interventional

Funder types: Other

Identifiers

NCT02859597

2016-6677

Details and patient eligibility

About

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.

Full description

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.

Enrollment: 41 patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Body Mass Index greater than or equal to 40
• Scheduled for a gastrointestinal endoscopy that requires MAC sedation

Exclusion criteria

• Body Mass Index less than 40
• Pregnant
• Require either invasive or non-invasive ventilation for respiratory failure
• Use home oxygen
• Ventilation is via a tracheostomy
• The procedure is emergent

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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41 participants in 2 patient groups

High Flow Nasal Cannula

Experimental group

Description:

High flow nasal cannula will be utilized to deliver oxygen to morbidly obese patients undergoing deep sedation for gastrointestinal procedures.

Treatment:

Device: High flow nasal cannula

Nasal Cannula

Active Comparator group

Description:

Typical nasal cannula will be utilized to deliver oxygen to morbidly obese patients undergoing deep sedation for gastrointestinal procedures.

Treatment:

Device: Nasal Cannula