Journal Article

Effect of supraglottic jet oxygenation and ventilation on hypoxemia in patients undergoing endoscopic surgery with sedation: A meta-analysis of randomized controlled trials

Shi, Hongwei, Jiang, Xue, Li, Zixuan, Xu, Rukun, Zhu, Lili, Xu, Yajie, Wei, Huafeng, Zhang, Wenwen, Zhang, Yong, Wang, Xiaoliang

2024

Overview

Nasal cannulas and face masks are common oxygenation tools used in conventional oxygen therapy for patients undergoing endoscopic surgery with sedation. However, as a novel supraglottic ventilation technique, the application of supraglottic jet oxygenation and ventilation (SJOV) in endoscopic surgery has not been well established. We searched six electronic databases from inception to January 16, 2024, to assess the oxygenation/ventilation efficacy and side effects of the of SJOV in endoscopic surgery. The primary outcome was the incidence of hypoxemia. The secondary outcomes were the incidence of respiratory depression and adverse effects (nasal bleeding, sore throat, and dry mouth). Nine trials involving 2017 patients were included. The results demonstrated that the incidence of hypoxemia was lower in the SJOV group compared with the conventional oxygen therapy (COT) group [9 trails; 2017 patients; risk ratio (RR) = 0.18; 95% confidence interval (CI), (0.11–0.28)]. Subgroup analyses showed that SJOV reduced the incidence of hypoxemia in the high-risk group but had no effect on the low-risk group. The incidence of respiratory depression is lower in SJOV than in COT, but has increased side effects such as dry mouth. There was no statistically significant difference in nose bleeding or sore throat between the two groups. Compared with the COT, the SJOV decreased the incidence of hypoxemia in high-risk patients during endoscopic surgery with sedation. There was an increased risk of dry mouth, but not of nose bleeding or sore throat, during endoscopic surgery under sedation. •Compared with COT, there was a significantly reduction of intraoperative hpoxemia during endoscopic surgery with SJOV.•SJOV can decrease the incidence of hypoxemia, especially in high-risk patients during the endoscopic surgery with sedation.•There was no increased risk of nose bleeding or sore throat between SJOV and COT group, except for dry mouth.

• Publisher: Elsevier Inc,Elsevier Limited
• Subject: Airway management / Anesthesia / Bronchoscopy / Clinical outcomes / Clinical trials / Colonoscopy / Conventional oxygen therapy / Endoscope / Endoscopy / Endoscopy - adverse effects / Endoscopy - methods / High-Frequency Jet Ventilation - adverse effects / High-Frequency Jet Ventilation - methods / Humans / Hypoxemia / Hypoxia - epidemiology / Hypoxia - etiology / Hypoxia - prevention & control / Incidence / Masks / Oxygen Inhalation Therapy - methods / Pain Medicine / Patients / Procedural Sedation - adverse effects / Procedural Sedation - methods / Randomized Controlled Trials as Topic / Respiratory Insufficiency - etiology / Respiratory Insufficiency - prevention & control / Sedation / Sensitivity analysis / Side effects / Software / Statistical analysis / Supraglottic jet oxygenation and ventilation / Surgery / Treatment Outcome / Ventilation