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

IF 5.7 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Japanese Dental Science Review Pub Date : 2022-11-01 DOI:10.1016/j.jdsr.2022.05.003

Shinji Kurata , Takuro Sanuki , Hitoshi Higuchi , Takuya Miyawaki , Seiji Watanabe , Shigeru Maeda , Shuntaro Sato , Max Pinkham , Stanislav Tatkov , Takao Ayuse

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Abstract

Structured summary

Rationale: Nasal high-flow (NHF), a new method for respiratory management during procedural sedation, has greater advantages than conventional nasal therapy with oxygen. However, its clinical relevance for patients undergoing oral maxillofacial surgery and/or dental treatment remains uncertain and controversial, due to a paucity of studies. This scoping review compared and evaluated NHF and conventional nasal therapy with oxygen in patients undergoing oral maxillofacial surgery and/or dental treatment.

Materials and methods

A literature search of two public electronic databases was conducted, and English writing randomized controlled trials (RCTs) of nasal high flow during dental procedure with sedation reviewed. The primary and secondary outcomes of interest were the incidence of hypoxemia and hypercapnia during sedation and the need for intervention to relieve upper airway obstruction, respectively.

Results

The search strategy yielded 7 studies, of which three RCTs met our eligibility criteria, with a total of 78 patients. Compared with conventional nasal therapy with oxygen, NHF significantly reduced the incidence of hypoxemia and hypercapnia during procedural sedation.

Conclusion

NHF can maintain oxygenation and possibly prevent hypercapnia in patients undergoing dental treatment. Additional RCTs are needed to clarify and confirm these findings.

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鼻高流量在镇静过程呼吸管理中的临床优势:对镇静牙科手术中鼻高流量应用的综述

理论基础:鼻高流量(NHF)是手术镇静过程中呼吸管理的一种新方法，与传统的鼻腔氧疗相比具有更大的优势。然而，由于研究的缺乏，其与接受口腔颌面外科手术和/或牙科治疗的患者的临床相关性仍然不确定和有争议。本综述比较和评估了在接受口腔颌面外科手术和/或牙科治疗的患者中使用NHF和常规鼻氧治疗。材料与方法检索两个公共电子数据库的文献，回顾镇静牙科手术中鼻腔高流量的英文写作随机对照试验(RCTs)。研究的主要和次要结局分别是镇静期间低氧血症和高碳酸血症的发生率，以及是否需要干预以缓解上呼吸道阻塞。结果检索策略获得7项研究，其中3项rct符合我们的入选标准，共计78例患者。与常规鼻氧治疗相比，NHF显著降低了手术镇静期间低氧血症和高碳酸血症的发生率。结论氟化氢能维持口腔治疗患者的氧合，并可能预防高碳酸血症的发生。需要更多的随机对照试验来澄清和证实这些发现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Japanese Dental Science Review DENTISTRY, ORAL SURGERY & MEDICINE-

CiteScore

9.90

自引率

1.50%

发文量

审稿时长

32 days

期刊介绍： The Japanese Dental Science Review is published by the Japanese Association for Dental Science aiming to introduce the modern aspects of the dental basic and clinical sciences in Japan, and to share and discuss the update information with foreign researchers and dentists for further development of dentistry. In principle, papers are written and submitted on the invitation of one of the Editors, although the Editors would be glad to receive suggestions. Proposals for review articles should be sent by the authors to one of the Editors by e-mail. All submitted papers are subject to the peer- refereeing process.