Phase II study comparing nasal pressure monitoring with capnography during invasive endoscopic procedures: a single-center, single-arm trial

• Published in: Scientific reports 2023-01, Vol.13 (1), p.1265-10, Article 1265
• Main Authors: Nagashima, Hiroki, Mikata, Rintaro, Isono, Shiroh, Ogasawara, Sadahisa, Sugiyama, Harutoshi, Ohno, Izumi, Yasui, Shin, Matsumura, Tomoaki, Koroki, Keisuke, Kusakabe, Yuko, Miura, Yoshifumi, Kan, Motoyasu, Maruta, Shikiko, Yamada, Toshihito, Takemura, Ryo, Sato, Yasunori, Kato, Jun, Kato, Naoya
• Format: Article
• Language: English
• Subjects: 692/308; 692/4020; Adult; Anesthesia; Apnea; Capnography - methods; Carbon dioxide; Endoscopy; False alarms; Fentanyl; Humanities and Social Sciences; Humans; Monitoring; Monitoring, Physiologic - methods; multidisciplinary; Pressure; Propofol; Propofol - adverse effects; Science; Science (multidisciplinary); Sleep Apnea, Obstructive - chemically induced; Sleep disorders
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-023-28213-y

Nasal pressure signal is commonly used to evaluate obstructive sleep apnea. This study aimed to assess its safety for respiratory monitoring during sedation. A total of 45 adult patients undergoing sedation with propofol and fentanyl for invasive endoscopic procedures were enrolled. While both nasal pressure and capnograph signals were continuously recorded, only the nasal pressure signal was displayed. The primary outcome was the incidence of oxygen desaturation below 90%. The secondary outcomes were the ability to predict the desaturation and incidence of harmful events and false alarms, defined as an apnea waveform lasting more than 3 min without desaturation. Of the 45 participants, 43 completed the study. At least one desaturation event occurred in 12 patients (27.9%; 95% confidence interval 15.3–43.7%). In these 12 patients, more than half of the desaturation events were predictable in 9 patients by capnography and 11 patients by nasal pressure monitoring ( p  = 0.59). In the 43 patients, false alarms were detected in 7 patients with capnography and 11 patients with nasal pressure monitoring ( p  = 0.427). Harmful events unrelated to nasal pressure monitoring occurred in 2 patients. Nasal pressure monitoring is safe and possibly useful for respiratory monitoring despite false alarms during sedation.