Trial Outcomes & Findings for Nasal Continuous Positive Airway Pressure Versus Standard Care During Procedural Sedation for Gastrointestinal Endoscopy (NCT NCT03369197)

NCT ID: NCT03369197

Last Updated: 2022-10-18

Results Overview

Number of subjects undergoing procedural sedation for endoscopy with at least one hypoxic event, defined as oxygen saturation less than 90 percent for 15 seconds.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

111 participants

Primary outcome timeframe

Approximately 1 hour

Results posted on

2022-10-18

Participant Flow

Patients were recruited in the Endoscopy suite at Johns Hopkins Hospital.

Participant milestones

Participant milestones
Measure
Intervention: Nasal Mask
Nasal anesthesia mask with positive pressure Nasal Mask: Nasal anesthesia mask which covers the nose and attaches to the anesthesia circuit, allowing for variable positive pressure by setting the pop-off valve
Control: Nasal Cannula
Nasal Cannula with standard care Control: Nasal Cannula: Nasal cannula as per usual care
Overall Study
STARTED
53
58
Overall Study
COMPLETED
53
58
Overall Study
NOT COMPLETED
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Nasal Continuous Positive Airway Pressure Versus Standard Care During Procedural Sedation for Gastrointestinal Endoscopy

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Intervention: Nasal Mask
n=53 Participants
Nasal anesthesia mask with positive pressure Nasal Mask: Nasal anesthesia mask which covers the nose and attaches to the anesthesia circuit, allowing for variable positive pressure by setting the pop-off valve
Control: Nasal Cannula
n=58 Participants
Nasal Cannula with standard care Control: Nasal Cannula: Nasal cannula as per usual care
Total
n=111 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Age, Categorical
Between 18 and 65 years
30 Participants
n=5 Participants
42 Participants
n=7 Participants
72 Participants
n=5 Participants
Age, Categorical
>=65 years
23 Participants
n=5 Participants
16 Participants
n=7 Participants
39 Participants
n=5 Participants
Sex: Female, Male
Female
24 Participants
n=5 Participants
29 Participants
n=7 Participants
53 Participants
n=5 Participants
Sex: Female, Male
Male
29 Participants
n=5 Participants
29 Participants
n=7 Participants
58 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants
n=5 Participants
1 Participants
n=7 Participants
1 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
53 Participants
n=5 Participants
57 Participants
n=7 Participants
110 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
2 Participants
n=5 Participants
1 Participants
n=7 Participants
3 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
7 Participants
n=5 Participants
12 Participants
n=7 Participants
19 Participants
n=5 Participants
Race (NIH/OMB)
White
42 Participants
n=5 Participants
44 Participants
n=7 Participants
86 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
2 Participants
n=5 Participants
1 Participants
n=7 Participants
3 Participants
n=5 Participants

PRIMARY outcome

Timeframe: Approximately 1 hour

Number of subjects undergoing procedural sedation for endoscopy with at least one hypoxic event, defined as oxygen saturation less than 90 percent for 15 seconds.

Outcome measures

Outcome measures
Measure
Intervention: Nasal Mask
n=53 Participants
Nasal anesthesia mask with positive pressure Nasal Mask: Nasal anesthesia mask which covers the nose and attaches to the anesthesia circuit, allowing for variable positive pressure by setting the pop-off valve
Control: Nasal Cannula
n=58 Participants
Nasal Cannula with standard care Control: Nasal Cannula: Nasal cannula as per usual care
Hypoxia Rate as Assessed by Number of Participants With at Least One Hypoxic Event
3 Participants
16 Participants

SECONDARY outcome

Timeframe: Approximately 1 hour

Population: 11 participants from intervention group and 9 participants from control group were not assessed for this outcome measure.

Evaluate hypoventilation in subjects undergoing procedural sedation for endoscopy by transcutaneous carbon dioxide monitoring in millimeters of mercury (mmHg).

Outcome measures

Outcome measures
Measure
Intervention: Nasal Mask
n=42 Participants
Nasal anesthesia mask with positive pressure Nasal Mask: Nasal anesthesia mask which covers the nose and attaches to the anesthesia circuit, allowing for variable positive pressure by setting the pop-off valve
Control: Nasal Cannula
n=48 Participants
Nasal Cannula with standard care Control: Nasal Cannula: Nasal cannula as per usual care
Hypoventilation in Subjects Undergoing Procedural Sedation for Endoscopy as Assessed by Transcutaneous Carbon Dioxide Monitoring
53.3 mmHg
Standard Deviation 6.20
51.9 mmHg
Standard Deviation 8.14

SECONDARY outcome

Timeframe: Approximately 1 hour

Population: Only 43 in the intervention group and 40 in the control group had sufficient data to be analyzed.

Evaluate hypoventilation by respiratory volume monitoring for minute ventilation. Reported result is the percentage decrease from baseline in minute ventilation.

Outcome measures

Outcome measures
Measure
Intervention: Nasal Mask
n=43 Participants
Nasal anesthesia mask with positive pressure Nasal Mask: Nasal anesthesia mask which covers the nose and attaches to the anesthesia circuit, allowing for variable positive pressure by setting the pop-off valve
Control: Nasal Cannula
n=40 Participants
Nasal Cannula with standard care Control: Nasal Cannula: Nasal cannula as per usual care
Hypoventilation in Subjects Undergoing Procedural Sedation for Endoscopy as Assessed by Respiratory Volume Monitoring
64 percentage of decrease
Standard Deviation 21.9
59 percentage of decrease
Standard Deviation 22

SECONDARY outcome

Timeframe: Approximately 1 hour

Population: This data was not collected.

Correlate respiratory volume monitoring transcutaneous carbon dioxide measurement with number of airway maneuvers to identify mechanism of hypoventilation as predominately obstructive or due to respiratory rate or tidal volume.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Approximately 1 hour

Population: 5 participants from intervention group and 7 participants from control group were not assessed for this outcome measure.

Depth of anesthesia by processed electroencephalogram (EEG) bispectral analysis, which is a standard monitor of anesthetic depth using a calibrated dimensionless index that ranges from 0 to 100, with lower numbers corresponding to a deeper anesthetic state.

Outcome measures

Outcome measures
Measure
Intervention: Nasal Mask
n=48 Participants
Nasal anesthesia mask with positive pressure Nasal Mask: Nasal anesthesia mask which covers the nose and attaches to the anesthesia circuit, allowing for variable positive pressure by setting the pop-off valve
Control: Nasal Cannula
n=50 Participants
Nasal Cannula with standard care Control: Nasal Cannula: Nasal cannula as per usual care
Depth of Anesthesia in Subjects Undergoing Procedural Sedation for Endoscopy
40.19 score on a scale
Standard Deviation 13.64
40.30 score on a scale
Standard Deviation 15.07

SECONDARY outcome

Timeframe: Approximately 1 hour

Population: This data was not collected.

The total time in seconds of oxygen saturation below 90 percent will be recorded

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Approximately 1 hour

Population: The 3 patients in nasal mask arm and 16 in nasal cannula arm experienced hypoxia.

In subjects experiencing hypoxia during sedation, the total number of episodes of hypoxia for all participants will be recorded.

Outcome measures

Outcome measures
Measure
Intervention: Nasal Mask
n=3 Participants
Nasal anesthesia mask with positive pressure Nasal Mask: Nasal anesthesia mask which covers the nose and attaches to the anesthesia circuit, allowing for variable positive pressure by setting the pop-off valve
Control: Nasal Cannula
n=16 Participants
Nasal Cannula with standard care Control: Nasal Cannula: Nasal cannula as per usual care
Total Number of Hypoxic Events in Subjects That Experienced Hypoxia
4 hypoxic events
23 hypoxic events

OTHER_PRE_SPECIFIED outcome

Timeframe: Approximately 1 hour

Measure baseline short chain fatty acids in subjects undergoing procedural sedation for endoscopy and correlate the concentration with the degree of respiratory depression by respiratory volume monitoring and transcutaneous carbon dioxide.

Outcome measures

Outcome data not reported

Adverse Events

Intervention: Nasal Mask

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Control: Nasal Cannula

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Dr. Laeben Lester

The Johns Hopkins University

Phone: 410-955-7519

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place