Recent Developments in Devices Used for Gastrointestinal Endoscopy Sedation

다국어 초록 (Multilingual Abstract)

Hypoxemia is a frequent and potentially fatal complication occurring in patients during gastrointestinal endoscopy. Theadministration of propofol sedation increases the risk of most complications, especially hypoxemia. Nevertheless, propofol has beenincreasingly used in the United States, and the trend is likely to increase in the years to come. Patient satisfaction and endoscopistsatisfaction along with rapid turnover are some of the touted reasons for this trend. However, propofol sedation generally impliesdeep sedation or general anesthesia. As a result, hypopnea and apnea frequently occur. Inadequate sedation and presence of irritableairway often cause coughing and laryngospasm, both leading to hypoxemia and potential cardiac arrest. Hence, prevention ofhypoxemia is of paramount importance. Traditionally, standard nasal cannula is used to administer supplement oxygen. However, itcannot sufficiently provide continuous positive airway pressure (CPAP) or positive pressure ventilation. Device manufacturers havestepped in to fill this void and created many types of cannulas that provide apneic insufflation of oxygen and CPAP and eliminatedead space. Such measures decrease the incidence of hypoxemia. This review aimed to provide essential information of some of thesedevices.

참고문헌 (Reference)

1 "Using OxyshieldTM" OxyshieldTM

2 Gedeon M, "Use of noninvasive positive pressure ventilation in patients with severe obesity undergoing esophagogastroduodenoscopy : a randomized controlled trial" 15 : 1589-1594, 2019

3 Parke RL, "The effects of flow on airway pressure during nasal high-flow oxygen therapy" 56 : 1151-1155, 2011

4 Fabbri C, "The Gastro-laryngeal tube for interventional endoscopic biliopancreatic procedures in anesthetized patients" 44 : 1051-1054, 2012

5 Qin Y, "Supraglottic jet oxygenation and ventilation enhances oxygenation during upper gastrointestinal endoscopy in patients sedated with propofol : a randomized multicentre clinical trial" 119 : 158-166, 2017

6 Goudra BG, "Significantly reduced hypoxemic events in morbidly obese patients undergoing gastrointestinal endoscopy : predictors and practice effect" 30 : 71-77, 2014

7 Wernli KJ, "Risks associated with anesthesia services during colonoscopy" 150 : 888-894, 2016

8 "Respa O2 Delivery Bite Block" STERIS

9 Goudra B, "Propofol and non-propofol based sedation for outpatient colonoscopy-prospective comparison of depth of sedation using an EEG based SEDLine monitor" 30 : 551-557, 2016

10 "Procedural Oxygen Mask" POM Medical

11 Goudra BG, "Outpatient endoscopic retrograde cholangiopancreatography : safety and efficacy of anesthetic management with a natural airway in 653 consecutive procedures" 7 : 259-265, 2013

12 Dimou F, "Nasal positive pressure with the SuperNO2VATM device decreases sedation-related hypoxemia during pre-bariatric surgery EGD" 33 : 3828-3832, 2019

13 Gleason JM, "Nasal cannula apneic oxygenation prevents desaturation during endotracheal intubation : an integrative literature review" 19 : 403-411, 2018

14 Zhu Y, "High-flow nasal cannula oxygen therapy versus conventional oxygen therapy in patients after planned extubation: a systematic review and meta-analysis" 23 : 180-, 2019

15 Nishimura M, "High-flow nasal cannula oxygen therapy devices" 64 : 735-742, 2019

16 Lin Y, "High-flow nasal cannula oxygen therapy and hypoxia during gastroscopy with propofol sedation : a randomized multicenter clinical trial" 90 : 591-601, 2019

17 Gaitini LA, "Gastro-laryngeal tube for endoscopic retrograde cholangiopancreatography : a preliminary report" 65 : 1114-1118, 2010

18 "Gastro-Laryngeal Tube (G-LT)" VBM Medizintechnik GmbH

19 "Endoscopy Mask, Bronchoscope Airway" VBM Medizintechnik GmbH

20 "Endoscopic Mask" DEAS

21 Terblanche NCS, "Efficacy of a new dual channel laryngeal mask airway, the LMA®GastroTM Airway, for upper gastrointestinal endoscopy : a prospective observational study" 120 : 353-360, 2018

22 Sahay N, "Effect of nasal oxygen supplementation during apnoea of intubation on arterial oxygen levels : a prospective randomised controlled trial" 61 : 897-902, 2017

23 "ELUXEO®700 Series Gastroscopes" Fujifilm USA

24 Barnett SR, "Deep sedation without intubation for ERCP is appropriate in healthier, non-obese patients" 58 : 3287-3292, 2013

25 Bai Y, "Comparison of a simplified nasal continuous positive airways pressure device with nasal cannula in obese patients undergoing colonoscopy during deep sedation : a randomised clinical trial" 36 : 633-640, 2019

26 Goudra B, "Cardiac arrests in patients undergoing gastrointestinal endoscopy : a retrospective analysis of 73, 029 procedures" 21 : 400-411, 2015

27 Basavana Goudra, "Association between Type of Sedation and the Adverse Events Associated with Gastrointestinal Endoscopy: An Analysis of 5 Years’ Data from a Tertiary Center in the USA" 대한소화기내시경학회 50 (50): 161-169, 2017

28 Goudra BG, "Anesthesia for ERCP : impact of anesthesiologist’s experience on outcome and cost" 2013 : 570518-, 2013

29 Bielawska B, "Anesthesia assistance in outpatient colonoscopy and risk of aspiration pneumonia, bowel perforation, and splenic injury" 154 : 77-85, 2018

30 Goudra BG, "A novel way of anesthetizing and maintaining airway/ventilation in an ultra-morbidly obese patient presenting for upper GI endoscopy" 24 : 604-605, 2012

31 Davis J, "A comparison of stress response between insertion of gastro-laryngeal tube and endotracheal intubation in patients undergoing upper gastrointestinal endoscopic procedures for endoscopic retrograde cholangiopancreatography" 13 : 13-18, 2019