An artificial neural network model for prediction of hypoxemia during sedation for gastrointestinal endoscopy

Geng, Wujun; Tang, Hongli; Sharma, Anshu; Zhao, Yizhou; Yan, Ye; Wang, Hong

doi:10.1177/0300060519834459

Cited by 14 publications

(21 citation statements)

References 13 publications

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“…Therefore our results agree substantially also with this report. Nevertheless, the present study's findings differ from those published by Geng et al [33] because they found no effect of age and ASA score on intraprocedural hypoxemia. These authors addressed only hypoxemia as an AE and did not consider some other important potentially predictive variables, such as in-hospital versus outpatient, the duration of the procedure, and the sedative drug association.…”

Section: Plos Onecontrasting

confidence: 99%

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Risk of adverse events in gastrointestinal endoscopy: Zero-inflated Poisson regression mixture model for count data and multinomial logit model for the type of event

et al. 2021

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Background and aims We analyze the possible predictive variables for Adverse Events (AEs) during sedation for gastrointestinal (GI) endoscopy. Methods We consider 23,788 GI endoscopies under sedation on adults between 2012 and 2019. A Zero-Inflated Poisson Regression Mixture (ZIPRM) model for count data with concomitant variables is applied, accounting for unobserved heterogeneity and evaluating the risks of multi-drug sedation. A multinomial logit model is also estimated to evaluate cardiovascular, respiratory, hemorrhagic, other AEs and stopping the procedure risk factors. Results In 7.55% of cases, one or more AEs occurred, most frequently cardiovascular (3.26%) or respiratory (2.77%). Our ZIPRM model identifies one population for non-zero counts. The AE-group reveals that age >75 years yields 46% more AEs than age <66 years; Body Mass Index (BMI) ≥27 27% more AEs than BMI <21; emergency 11% more AEs than routine. Any one-point increment in the American Society of Anesthesiologists (ASA) score and the Mallampati score determines respectively a 42% and a 16% increment in AEs; every hour prolonging endoscopy increases AEs by 41%. Regarding sedation with propofol alone (the sedative of choice), adding opioids to propofol increases AEs by 43% and adding benzodiazepines by 51%. Cardiovascular AEs are increased by age, ASA score, smoke, in-hospital, procedure duration, midazolam/fentanyl associated with propofol. Respiratory AEs are increased by BMI, ASA and Mallampati scores, emergency, in-hospital, procedure duration, midazolam/fentanyl associated with propofol. Hemorrhagic AEs are increased by age, in-hospital, procedure duration, midazolam/fentanyl associated with propofol. The risk of suspension of the endoscopic procedure before accomplishment is increased by female gender, ASA and Mallampati scores, and in-hospital, and it is reduced by emergency and procedure duration. Conclusions Age, BMI, ASA score, Mallampati score, in-hospital, procedure duration, other sedatives with propofol increase the risk for AEs during sedation for GI endoscopy.

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Section: Plos Onecontrasting

confidence: 99%

“…In a recent study conducted by Geng et al [33] and based on a much smaller sample (220 cases), it was reported that hypoxemia occurring during GI endoscopy is favored by BMI, habitual snoring, and neck circumference. It is conceivable that snoring and neck circumference may be associated with a higher Mallampati score.…”

Section: Plos Onementioning

confidence: 97%

Risk of adverse events in gastrointestinal endoscopy: Zero-inflated Poisson regression mixture model for count data and multinomial logit model for the type of event

et al. 2021

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“…It has been proven that obesity (body mass index, BMI>30 kg/m 2 ) is an independent risk factor for sedation-related adverse events [34,35]. Obese patients' respiratory physiology has the following features: first, hypertrophic chest wall hypertrophy, decreased thoracic compliance, high respiratory resistance, and a propensity for respiratory muscle fatigue in obese patients; second, the airway anatomical structure in obese patients is changed, such as short neck, neck activity restriction, and fat deposition in the pharyngeal wall [31,36]; third, baseline oxygen consumption increased as body mass index grew, whereas functional residual gas and oxygen reserve dropped [37].…”

Section: Obesity Patientsmentioning

confidence: 99%

Research Progress on Prevention and Treatment of Hypoxemia in Painless Gastroscopy: A Review Article

Tan

2023

Asp Biomed Clin Case Rep

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Compared to ordinary gastroscopy, painless gastroscopy has more advantages due to the application of anesthesia techniques such as sedation and analgesia, providing patients with comfort and a quick recovery. However, patients undergoing painless gastroscopy are often at risk of hypoxia, which can result in serious complications. Fortunately, more anesthesia providers have recognized this problem. Therefore, it is essential for anesthesia providers to identify risk factors to prevent hypoxemia. In conclusion, this review highlights the assessment of risk factors for hypoxemia in painless gastroscopy and common airway management methods to prevent and treat hypoxemia in high-risk populations during painless endoscopy.

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“…Patients with risk factors of hypoxemia (age > 60 years old, obesity, heart/respiratory failure, diabetes, hypertension, obstructive sleep apnea) and ASA 2 patients may benefit from a high nasal flow oxygenation (HFO) [20,21]. Patients with a high STOP-BANG score, are prone to develop adverse respiratory events and require more maneuvers to control airways [22 & ].…”

Section: Airway Managementmentioning

confidence: 99%

Anesthesia for digestive tract endoscopy

Pardo

Camus

Verdonk

2022

Current Opinion in Anaesthesiology

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Purpose of reviewNonoperating room anesthesia for digestive tract endoscopy has its own specificities and requires practical training. Monitoring devices, anesthetic drugs, understanding of procedures and management of complications are critical aspects. Recent findingsNew data are available regarding risk factors for intra-and postoperative complications (based on anesthesia registries), airway management, new anesthetic drugs, techniques of administration and management of advances in interventional endoscopy procedures. SummaryDigestive tract endoscopy is a common procedure that takes place outside the operating room most of the time and has become more and more complex due to advanced invasive procedures. Prior evaluation of the patient's comorbidities and a good understanding of the objectives and constraints of the endoscopic procedures are required. Assessing the risk of gastric content aspiration is critical for determining appropriate anesthetic protocols. The availability of adequate monitoring (capnographs adapted to spontaneous ventilation, bispectral index), devices for administration of anesthetic/sedative agents (targetcontrolled infusion) and oxygenation (high flow nasal oxygenation) guarantees the quality of sedation and patient' safety during endoscopic procedures. Knowledge of the specificities of each interventional endoscopic procedure (endoscopic retrograde cholangiopancreatography, submucosal dissection) allows preventing complications during anesthesia.

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An artificial neural network model for prediction of hypoxemia during sedation for gastrointestinal endoscopy

Cited by 14 publications

References 13 publications

Risk of adverse events in gastrointestinal endoscopy: Zero-inflated Poisson regression mixture model for count data and multinomial logit model for the type of event

Risk of adverse events in gastrointestinal endoscopy: Zero-inflated Poisson regression mixture model for count data and multinomial logit model for the type of event

Research Progress on Prevention and Treatment of Hypoxemia in Painless Gastroscopy: A Review Article

Anesthesia for digestive tract endoscopy

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