Comparison of Oxygen Saturation Between Nasal High-Flow Oxygen and Conventional Nasal Cannula in Obese Patients Undergoing Dental Procedures With Deep Sedation: A Randomized Crossover Trial

The clinical advantage of nasal high-flow in respiratory management during procedural sedation: A scoping review on the application of nasal high-flow during dental procedures with sedation

“…Patients were randomized to either the nasal cannula control group (5 L/min) or NHF (30, 40 or 50 L/min) treatment group. In obese patients (BMI>25), the partial pressure of arterial carbon dioxide (PaCO 2 ) was 50.1 ± 6.0 mmHg (95 % CI 47.2–53.1) in the control group and 47.6 ± 4.8 mmHg (95 % CI 45.2–50.0) in the NHF (40 % O 2 , 40 L/min) group (P = 0.018) [15] . In pediatric dental patients, the lowest peripheral capillary oxygen saturation values during treatment were higher in the NHF group (2 kg/L/min up to a maximum of 30 L/min) compared to the control group (P < 0.05) [17] .…”

“…Three of these articles were related to English NHF RCTs during dental procedure with sedation. Further screening of the full texts identified three RCTs that met our inclusion criteria [15] , [17] , [18] . The data extracted from these RCTs are detailed in Table 1 .…”

“…Alterations in the PaCO 2 are rarely measured during surgical procedures. However, at least one study found that the PaCO 2 was lower in patients that received NHF therapy compared to controls [15] . In that study, the PaCO 2 was measured once, at the 10 min time point after the beginning of the dental procedure in obese patients with intellectual disabilities.…”

“…Furthermore, NHF therapy prevented hypoxia in adult dental patients. In a letter to the editor concerning the article by Higuchi et al [15] , several key points were made regarding the clinical implications of the criteria for defining hypoxemia, interpretation of interventions such as chin lift, explanation for head position, and the occurrence rate of hypoxia during procedural sedation for dental treatment [19] . In another letter to the editor [20] concerning the article by Sago et.…”

“…Recently, we reported that NHF improves ventilation during propofol sedation, which may reduce the risk of complications related to hypoventilation [14] . In addition, some effects of NHF, such as increased functional residual capacity and end-expiratory lung volume, can improve oxygen saturation in obese patients [15] .…”