High-Flow Nasal Cannula for Apneic Oxygenation in Obese Patients for Elective Surgery: A Systematic Review and Meta-Analysis
Pooled resultResult — go to the resultOdds ratio 0.49 95% CI 0.15–1.63Authors' conclusion
There may be no difference between HFNC and FM preoxygenation in preventing oxygen desaturation <92% or the lowest oxygen saturation before intubation.
Study context
- Population
- Obese adults requiring GA for elective surgery
- Participants
- 351 adults · 6 studies
- Comparison
- HFNC vs facemask preoxygenation
- Outcome
- Desaturation to SpO2 <92% from induction of anesthesia until intubation
Methodological detailsGrading of Recommendations Assessment, Development, and Evaluation (GRADE) certainty assessment, Cochrane risk of bias tool
- GRADE certainty assessment
- Cochrane risk of bias tool
Pooled result
As reported in the abstract
Odds ratio
0.49
95% CI 0.15–1.63
P = 0.24
HFNC vs FM
OR 0.49 (95% CI 0.15–1.63); P = 0.24
Further pooled results
| Outcome | MD (seconds) (95% CI) | P value | |
|---|---|---|---|
| Safe apnea timeSignificantly longer in HFNC · very low certainty (GRADE) | −124.20 (−200.47 to −47.93) | P = 0.001 | |
| −300−200−1000100Difference, seconds (linear scale) |
| Outcome | MD (mm Hg) (95% CI) | P value | |
|---|---|---|---|
| Lowest arterial oxygen content before intubationVery low certainty (GRADE) | −23.90 (−88.64 to 40.85) | P = 0.47 | |
| −100−50050Difference, mm Hg (linear scale) |
| Outcome | MD (%) (95% CI) | P value | |
|---|---|---|---|
| Lowest peripheral oxygen saturation before intubationVery low certainty (GRADE) | −0.47 (−5.07 to 4.12) | P = 0.84 | |
| −10−505Difference, % (linear scale) |
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| Patient-reported discomfortModerate certainty (GRADE) | 0.13 (0.03–0.52) | P = 0.004 | |
| 0.050.21520Odds ratio (log scale) |
Safety
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| Aspiration of gastric contents during intubationVery low certainty (GRADE) | 0.33 (0.01–8.21) | P = 0.50 | |
| 0.050.21520Odds ratio (log scale) |
Original publication
High-Flow Nasal Cannula for Apneic Oxygenation in Obese Patients for Elective Surgery: A Systematic Review and Meta-Analysis. Anesth Analg. Published 5 December 2022. doi:10.
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