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Abstract：
This study aimed to systematically evaluate the clinical effects of using transnasal high-flow nasal cannula (HFNC) and conventional oxygen therapy (COT) in patients undergoing gastrointestinal endoscopy.
A comprehensive literature search was conducted from 2004 to April 2024 to collect relevant studies on the application of HFNC in patients undergoing gastrointestinal endoscopy. Multiple Chinese and English databases, including China National Knowledge Infrastructure (CNKI), Wanfang Data, Web of Science, PubMed, and Cochrane Library, were searched systematically for randomized controlled trials (RCTs). Two researchers independently screened the literature, extracted data, and assessed the risk of bias in the included studies. RevMan 5.4 software was utilized for conducting the network meta-analysis.
A total of 12 RCTs involving 3,726 patients were included. Meta-analysis results showed that HFNC reduced the incidence of hypoxemia and improved the minimum oxygen saturation (SpO2) compared with COT [odds ratio (OR) = 0.39, 95% confidence interval (CI): 0.29-0.53], [mean difference (MD) = 4.07, 95% CI: 3.14-5.01], and the difference was statistically significant. However, the baseline SpO2 levels and incidence of hypercapnia were not statistically significantly different between the HFNC and COT groups [MD = -0.21, 95% CI: -0.49-0.07]; [OR = 1.43, 95% CI: 0.95-2.15]. In terms of procedure time, the difference between HFNC and COT was not statistically significant, and subgroup analyses were performed for the different types of studies, with standard deviation in the gastroscopy group (MD = 0.09, 95% CI: -0.07-0.24) and the endoscopic retrograde cholangiopancreatography group (MD = 0.36, 95% CI: -0.50-1.23). The results demonstrated a significant reduction in the adoption of airway interventions in the HFNC group compared to the COT group (OR = 0.16, 95% CI: 0.05-0.53), with a statistically significant difference; this result was consistent with those of the included studies.
The application of HFNC improves the incidence of hypoxemia, enhances oxygenation, and reduces airway interventions during gastrointestinal endoscopy. However, HFNC does not significantly affect baseline SpO2, hypercapnia, or procedure time. The limitations of this study must be acknowledged, and further high-quality studies should be conducted to validate these findings.
A comprehensive literature search was conducted from 2004 to April 2024 to collect relevant studies on the application of HFNC in patients undergoing gastrointestinal endoscopy. Multiple Chinese and English databases, including China National Knowledge Infrastructure (CNKI), Wanfang Data, Web of Science, PubMed, and Cochrane Library, were searched systematically for randomized controlled trials (RCTs). Two researchers independently screened the literature, extracted data, and assessed the risk of bias in the included studies. RevMan 5.4 software was utilized for conducting the network meta-analysis.
A total of 12 RCTs involving 3,726 patients were included. Meta-analysis results showed that HFNC reduced the incidence of hypoxemia and improved the minimum oxygen saturation (SpO2) compared with COT [odds ratio (OR) = 0.39, 95% confidence interval (CI): 0.29-0.53], [mean difference (MD) = 4.07, 95% CI: 3.14-5.01], and the difference was statistically significant. However, the baseline SpO2 levels and incidence of hypercapnia were not statistically significantly different between the HFNC and COT groups [MD = -0.21, 95% CI: -0.49-0.07]; [OR = 1.43, 95% CI: 0.95-2.15]. In terms of procedure time, the difference between HFNC and COT was not statistically significant, and subgroup analyses were performed for the different types of studies, with standard deviation in the gastroscopy group (MD = 0.09, 95% CI: -0.07-0.24) and the endoscopic retrograde cholangiopancreatography group (MD = 0.36, 95% CI: -0.50-1.23). The results demonstrated a significant reduction in the adoption of airway interventions in the HFNC group compared to the COT group (OR = 0.16, 95% CI: 0.05-0.53), with a statistically significant difference; this result was consistent with those of the included studies.
The application of HFNC improves the incidence of hypoxemia, enhances oxygenation, and reduces airway interventions during gastrointestinal endoscopy. However, HFNC does not significantly affect baseline SpO2, hypercapnia, or procedure time. The limitations of this study must be acknowledged, and further high-quality studies should be conducted to validate these findings.
摘要：
■本研究旨在系统地评估在接受胃肠内窥镜检查的患者中使用经鼻高流量鼻套管（HFNC）和常规氧疗（COT）的临床效果。
■从2004年至2024年4月进行了全面的文献检索，以收集有关HFNC在接受胃肠内窥镜检查的患者中应用的相关研究。多个中文和英文数据库，包括中国国家知识基础设施(CNKI)，万方数据,WebofScience,PubMed,和Cochrane图书馆,系统搜索随机对照试验（RCTs）。两名研究人员独立筛选了文献，提取的数据，并评估纳入研究的偏倚风险。采用RevMan5.4软件进行网络荟萃分析。
■共纳入12个RCT，涉及3,726例患者。Meta分析结果显示，与COT相比，HFNC降低了低氧血症的发生率，改善了最低血氧饱和度（SpO2）[比值比（OR）=0.39，95％置信区间（CI）：0.29-0.53]。[平均差（MD）=4.07，95%CI：3.14-5.01]，差异有统计学意义。然而,HFNC组和COT组的基线SpO2水平和高碳酸血症发生率无统计学差异[MD=-0.21,95%CI:-0.49~0.07];[OR=1.43,95%CI:0.95~2.15].就手术时间而言，HFNC和COT之间的差异无统计学意义，并对不同类型的研究进行了亚组分析，胃镜组（MD=0.09，95％CI：-0.07-0.24）和内镜逆行胰胆管造影术组（MD=0.36，95％CI：-0.50-1.23）的标准偏差。结果表明，与COT组相比，HFNC组采用气道干预措施显着减少（OR=0.16，95％CI：0.05-0.53），差异具有统计学意义；该结果与纳入研究的结果一致。
■HFNC的应用改善了低氧血症的发生率，增强氧合，并减少胃肠内窥镜检查期间的气道干预。然而,HFNC不显著影响基线SpO2、高碳酸血症、或程序时间。必须承认这项研究的局限性，应开展进一步的高质量研究来验证这些发现.
■从2004年至2024年4月进行了全面的文献检索，以收集有关HFNC在接受胃肠内窥镜检查的患者中应用的相关研究。多个中文和英文数据库，包括中国国家知识基础设施(CNKI)，万方数据,WebofScience,PubMed,和Cochrane图书馆,系统搜索随机对照试验（RCTs）。两名研究人员独立筛选了文献，提取的数据，并评估纳入研究的偏倚风险。采用RevMan5.4软件进行网络荟萃分析。
■共纳入12个RCT，涉及3,726例患者。Meta分析结果显示，与COT相比，HFNC降低了低氧血症的发生率，改善了最低血氧饱和度（SpO2）[比值比（OR）=0.39，95％置信区间（CI）：0.29-0.53]。[平均差（MD）=4.07，95%CI：3.14-5.01]，差异有统计学意义。然而,HFNC组和COT组的基线SpO2水平和高碳酸血症发生率无统计学差异[MD=-0.21,95%CI:-0.49~0.07];[OR=1.43,95%CI:0.95~2.15].就手术时间而言，HFNC和COT之间的差异无统计学意义，并对不同类型的研究进行了亚组分析，胃镜组（MD=0.09，95％CI：-0.07-0.24）和内镜逆行胰胆管造影术组（MD=0.36，95％CI：-0.50-1.23）的标准偏差。结果表明，与COT组相比，HFNC组采用气道干预措施显着减少（OR=0.16，95％CI：0.05-0.53），差异具有统计学意义；该结果与纳入研究的结果一致。
■HFNC的应用改善了低氧血症的发生率，增强氧合，并减少胃肠内窥镜检查期间的气道干预。然而,HFNC不显著影响基线SpO2、高碳酸血症、或程序时间。必须承认这项研究的局限性，应开展进一步的高质量研究来验证这些发现.
