Nasal high flow improves ventilation during propofol sedation: A randomized cross-over study in healthy volunteers
Gaku Mishima, Takuro Sanuki, James A. Revie, Max Pinkham, Toshihiro Watanabe, Shinji Kurata, Stanislav Tatkov, Takao Ayuse
Abstract
Hypoventilation and carbon dioxide (CO2) retention are common during sedation. The current study investigated the ventilation responses to nasal high flow (NHF) during sedation with propofol. NHF of 30 L/min and 60 L/min with room air was applied during wakefulness and sedation in 10 male volunteers. Ventilation was monitored by respiratory inductance plethysmography, transcutaneous partial pressure of CO2 (TcCO2), and SpO2. During sedation, NHF of 30 L/min and 60 L/min reduced the TcCO2 by 2.9 ± 2.7 mmHg (p = 0.025) and by 3.6 ± 3.4 mmHg (p = 0.024) without affecting SpO2 and reduced the mean respiratory rate by 3 ± 3 breaths/min (p = 0.011) and by 4 ± 3 breaths/min (p = 0.003), respectively. During sedation with propofol, NHF without supplemental oxygen attenuated CO2 retention and reduced the respiratory rate. The findings show that NHF can improve ventilation during sedation, which may reduce the risk of complications related to hypoventilation.