High-Flow Nasal Oxygen and Desaturation During Deep Sedation for Colonoscopy in Patients at Increased Respiratory Risk: A Propensity Score-Matched Cohort Study
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background/Objectives Hypoxaemia is the most common adverse event during procedural sedation. High-flow nasal ox-ygen (HFNO) may reduce desaturation through continuous positive airway pressure, elimination of anatomical dead space, and precise FiO₂ delivery. This study aimed to assess the association between HFNO and the incidence of desaturation (SpO₂ < 90% at any time) during deep seda-tion for colonoscopy in a high-risk population. Methods A single-centre retrospective cohort study with propensity score matching was performed. It in-cluded 200 consecutive adult patients at high risk of adverse respiratory events undergoing deep sedation, grouped by oxygen delivery device: HFNO via nasal cannula versus Venturi mask. Results After 1:1 nearest-neighbour propensity score matching, 71 matched pairs were obtained. In the matched cohort, desaturation occurred in 12.7% of patients receiving HFNO versus 22.5% of controls (matched-pairs OR 0.53; 95% CI: 0.23–1.23; p = 0.211; McNemar's test), an absolute risk reduction of 9.8 percentage points. A sensitivity analysis using conditional logistic regression confirmed the direction and magnitude of the effect (adjusted OR 0.52; 95% CI: 0.22–1.21; p = 0.129). Post hoc power analysis indicated 30.8% statistical power in the current sample; 265 matched pairs would be required to achieve 80% power. Conclusions HFNO was associated with a meaningful reduction in the likelihood of desaturation during deep sedation for colonoscopy in a high-risk population (OR 0.53), consistent with available me-ta-analytic evidence for this risk stratum. This study provides a data-derived sample size estimate (265 matched pairs) for a future prospective randomised trial.
Source: Journal of Clinical Medicine
DOI: 10.3390/jcm15218254
Language: English
Subfield: Anesthesiology and Pain Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,137
OpenAlex ID: W7204827204