评估基于心电图的胸阻抗呼吸描记法减少内窥镜检查中缺氧事件的功效。这是一项单中心、1:1 随机对照试验。该试验是在经皮内窥镜胃造口术 (PEG) 放置期间进行的。 173接受 PEG 植入的患者被纳入本试验。大多数患者（89%）的适应症是肿瘤学。 58% 的患者为 ASA II 级，42% 的患者为 ASA III 级。患者被随机分为带脉搏血氧饱和度和自动血压测量的标准监测组 (SM) 或带额外胸部阻抗呼吸描记术 (TIM) 的干预组。由胃肠病学家或经过培训的护士使用异丙酚进行镇静。缺氧发作定义为 SpO2 < 90% 持续 > 15 秒是主要终点。次要终点是最低 SpO2、呼吸暂停 >10s/>30s 和产生的费用。额外使用胸廓阻抗呼吸描记术可减少缺氧发作（TIM：31% vs SM：49%；p = 0.016；OR 0.47；NNT 5.6）并提高最低 SpO2每次手术（TIM：90.0% ± 8.9；SM：84.0% ± 17.6；p = 0.007）显着。与 SM（1%；0%；p < 0.001；p = 0.014）相比，TIM 中检测到 >10 秒和 > 30 秒的呼吸暂停事件的频率明显更高（43%；7%），导致事件发生前有 17 秒的时间优势缺氧事件。因此，SM 患者比 TIM 患者更需要调整氧气流量 (p = 0.034)，而与 SM 患者 (9%；p = 0.053) 相比，TIM 患者 (2%) 需要辅助通气的频率较低。额外使用胸部阻抗呼吸描记术的计算成本为每次手术 0.13 美元（0.12 欧元/0.11 英镑）。额外的胸部阻抗呼吸描记术减少了缺氧事件的数量和程度，同时减少了辅助通气的需要。每次手术的补充费用可以忽略不计。胸阻抗呼吸描记法、二氧化碳图、镇静、监测、胃肠内窥镜检查、经皮内窥镜胃造口术。版权所有 © 2024 作者。由爱思唯尔公司出版。保留所有权利。

To assess the efficacy of an ECG-based method called thoracic impedance pneumography to reduce hypoxic events in endoscopy.This was a single center, 1:1 randomized controlled trial.The trial was conducted during the placement of percutaneous endoscopic gastrostomy (PEG).173 patients who underwent PEG placement were enrolled in the present trial. Indication was oncological in most patients (89%). 58% of patients were ASA class II and 42% of patients ASA class III.Patients were randomized in the standard monitoring group (SM) with pulse oximetry and automatic blood pressure measurement or in the intervention group with additional thoracic impedance pneumography (TIM). Sedation was performed with propofol by gastroenterologists or trained nurses.Hypoxic episodes defined as SpO2 < 90% for >15 s were the primary endpoint. Secondary endpoints were minimal SpO2, apnea >10s/>30s and incurred costs.Additional use of thoracic impedance pneumography reduced hypoxic episodes (TIM: 31% vs SM: 49%; p = 0.016; OR 0.47; NNT 5.6) and elevated minimal SpO2 per procedure (TIM: 90.0% ± 8.9; SM: 84.0% ± 17.6; p = 0.007) significantly. Apnea events >10s and > 30s were significantly more often detected in TIM (43%; 7%) compared to SM (1%; 0%; p < 0.001; p = 0.014) resulting in a time advantage of 17 s before the occurrence of hypoxic events. As a result, adjustments of oxygen flow were significantly more often necessary in SM than in TIM (p = 0.034) and assisted ventilation was less often needed in TIM (2%) compared with SM (9%; p = 0.053). Calculated costs for the additional use of thoracic impedance pneumography were 0.13$ (0.12 €/0.11 £) per procedure.Additional thoracic impedance pneumography reduced the quantity and extent of hypoxic events with less need of assisted ventilation. Supplemental costs per procedure were negligible.thoracic impedance pneumography, capnography, sedation, monitoring, gastrointestinal endoscopy, percutaneous endoscopic gastrostomy.Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.