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387880

Non-invasive carbon dioxide monitoring during moderate sedation at different oxygen flow rates in patients undergoing endoscopic retrograde cholangio-pancreatography

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Last updated: 05 Jan 2025

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Abstract

Background
All patients receiving sedation to facilitate endoscopic procedures should have monitoring of cardiorespiratory parameters before, during, and after administration of sedation/analgesia. We evaluated the effects of different O flow rates on the non-invasive CO monitoring (EtCO) in adult patients that were breathing spontaneously under moderate sedation during ERCP.
Methods
This prospective randomized double-blind study was conducted on 120 patients assigned randomly to one of the three equal groups (n = 40) (Group I; 2 L/min oxygen flow rate, Group II; 4 L/min oxygen flow rate, and Group III; 6 L/min oxygen flow rate). Primary outcome was EtCO at the end of procedure. Secondary outcomes included peripheral O saturation, hemodynamics, time to recovery, total propofol dose, patients’ satisfaction, sedation score, and complications.
Results
EtCO increased significantly between the studied groups at pre-intervention, induction, 5, 10, 20, and 30 min but without any clinical significance (p-value ˂ 0.05). The HR changes were statistically significant at 10 and 20 min after induction of anesthesia. While SpO, MBP, and RR differences were statistically not significant between groups throughout the whole study periods (p-value >0.05). Arterial blood gas analysis showed PCO was significantly different between the study groups but still within the normal range of readings, while pH and HCO showed statistically insignificant differences between the three groups.
Conclusion
The study demonstrated that different O flow rates did not affect the non-invasive EtCO measurements by the Dual-Guard device during moderate sedation in patients undergoing ERCP. Non-invasive EtCO monitoring can provide an early warning sign of hypoventilation during moderate sedation.

DOI

TEJA-2022-0231

Keywords

non-invasive, carbon dioxide monitoring, Moderate sedation, oxygen flow rates, Endoscopic retrograde cholangio-pancreatography

Authors

First Name

Mohamed F.

Last Name

Mostafa

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Affiliation

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Orcid

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First Name

Ayman

Last Name

Mamdouh Osman

MiddleName

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Affiliation

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Email

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City

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Orcid

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First Name

Ahmed

Last Name

Reda Mohamed Abdallah

MiddleName

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Affiliation

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Email

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City

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Orcid

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First Name

Ahmed

Last Name

Mostafa Thabet

MiddleName

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Affiliation

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Email

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City

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Orcid

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First Name

Shimaa

Last Name

Abbas Hassan

MiddleName

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Affiliation

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Email

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City

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Orcid

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Volume

39

Article Issue

1

Related Issue

51163

Issue Date

2023-12-01

Receive Date

2022-11-23

Publish Date

2023-12-31

Page Start

63

Page End

71

Print ISSN

1110-1849

Online ISSN

1687-1804

Link

https://egja.journals.ekb.eg/article_387880.html

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https://egja.journals.ekb.eg/service?article_code=387880

Order

387,880

Publication Type

Journal

Publication Title

Egyptian Journal of Anaesthesia

Publication Link

https://egja.journals.ekb.eg/

MainTitle

Non-invasive carbon dioxide monitoring during moderate sedation at different oxygen flow rates in patients undergoing endoscopic retrograde cholangio-pancreatography

Details

Type

Article

Created At

21 Dec 2024