Modified Manual Chest Compression for Prevention and Treatment of Respiratory Depression in Patients Under Deep Sedation During Upper Gastrointestinal Endoscopy: Two Randomized Controlled Trials
Authors' conclusion
MMCC may exert preventive and therapeutic effects against oxygen desaturation events during upper gastrointestinal endoscopy.
Study context
- Population
- Outpatients under deep sedation during upper gastrointestinal endoscopy440 preventive, 144 therapeutic
- Participants
- 584 participants
- Comparison
- Modified manual chest compression vs control/conventional treatment
- Primary endpoint
- Preventive cohort: incidence of desaturation episodes with SpO2 < 95%; therapeutic cohort: time spent below 95% SpO2
Methodological detailstwo randomised trials (preventive and therapeutic cohorts)
- Two randomised trials (preventive and therapeutic cohorts)
Primary result
As reported in the abstract
Desaturation SpO2 <95% (preventive) and time below 95% SpO2 (therapeutic)
M1
14.4%
C1
26.1%
M2
40
median · IQR 20–69 · seconds
C2
91
median · IQR 33–152 · seconds
Relative risk (95% CI)P value
M1 vs C1
0.549(0.37–0.815)
P = 0.002Median difference, seconds (95% CI)P value
M2 vs C2
−39(−57 to −16)
P < 0.001Secondary outcomes
| Outcome | M1 | C1 | M2 | C2 | RR (95% CI) | P value | |
|---|---|---|---|---|---|---|---|
| Diaphragmatic pause (preventive) · 30 seconds after propofol injectionM1 vs C1 | 74.5% | 88.1% | — not stated in the abstract | — not stated in the abstract | 0.846 (0.772–0.928) | P < 0.001 | |
| 0.512Relative risk (log scale) |
— not stated in the abstract
cm
| Outcome | M1 | C1 | M2 | C2 | Median difference (cm) (95% CI) | P value | |
|---|---|---|---|---|---|---|---|
| Diaphragmatic movement (therapeutic) · 30 seconds after SpO2 <95%M2 vs C2 | — not stated in the abstract | — not stated in the abstract | 1.11 (IQR 0.93–1.4) | 1.03 (IQR 0.7–1.24) | 0.16 (0.02–0.32) | P = 0.015 | |
| −0.200.20.4Difference, cm (linear scale) |
— not stated in the abstract
| Outcome | M1 | C1 | M2 | C2 | P value |
|---|---|---|---|---|---|
| Gastroscopy withdrawal (preventive)M1 vs C1 | 0% | 2.29% | — not stated in the abstract | — not stated in the abstract | P = 0.008 |
| Gastroscopy withdrawal (therapeutic)M2 vs C2 | — not stated in the abstract | — not stated in the abstract | 0% | 10.4% | P = 0.018 |
— not stated in the abstract
Original publication
Modified Manual Chest Compression for Prevention and Treatment of Respiratory Depression in Patients Under Deep Sedation During Upper Gastrointestinal Endoscopy: Two Randomized Controlled Trials. Anesth Analg. Published 3 April 2023. doi:10.
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