The utility of high-flow oxygen during emergency department procedural sedation and analgesia with propofol: a randomized, controlled trial.
Publication/Presentation Date
10-1-2011
Abstract
STUDY OBJECTIVE: We determine whether high-flow oxygen reduces the incidence of hypoxia by 20% in adults receiving propofol for emergency department (ED) sedation compared with room air.
METHODS: We randomized adults to receive 100% oxygen or compressed air at 15 L/minute by nonrebreather mask for 5 minutes before and during propofol procedural sedation. We administered 1.0 mg/kg of propofol, followed by 0.5 mg/kg boluses until the patient was adequately sedated. Physicians and patients were blinded to the gas used. Hypoxia was defined a priori as an oxygen saturation less than 93%; respiratory depression was defined as an end tidal CO(2) greater than 50 mm Hg, a 10% absolute change from baseline, or loss of waveform.
RESULTS: We noted significantly less hypoxia in the 59 patients receiving high-flow oxygen compared with the 58 receiving compressed air (19% versus 41%; P=.007; difference 23%; 95% confidence interval 6% to 38%). Respiratory depression was similar between groups (51% versus 48%; difference 2%; 95% confidence interval -15% to 22%). We observed 2 adverse events in the high-flow group (1 hypotension, 1 bradycardia) and 2 in the compressed air group (1 assisted ventilation, 1 hypotension).
CONCLUSION: High-flow oxygen reduces the frequency of hypoxia during ED propofol sedation in adults.
Volume
58
Issue
4
First Page
360
Last Page
364
ISSN
1097-6760
Published In/Presented At
Deitch, K., Chudnofsky, C. R., Dominici, P., Latta, D., & Salamanca, Y. (2011). The utility of high-flow oxygen during emergency department procedural sedation and analgesia with propofol: a randomized, controlled trial. Annals of emergency medicine, 58(4), 360–364.e3. https://doi.org/10.1016/j.annemergmed.2011.05.018
Disciplines
Medicine and Health Sciences
PubMedID
21680059
Department(s)
Fellows and Residents
Document Type
Article