Evidence map›Paper›PMID 42504139›Full record

Trial reportAnnals of medicine2026

High-flow nasal cannula oxygenation in sedated endoscopy for high-risk obstructive sleep apnea patients: study protocol for a multicentre randomised controlled trial.

Mingxia Xu, Saiheng Xiang, Yongmin Pi, Yuhuan Zhu, Xiaotong Chen, Qinqin Yang, Huawei Wu, Kan Deng, Yi Yin, Diansan Su

Registry-linked trialAbstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in Annals of medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07307560 (High-Flow Nasal Cannula for Preventing Hypoxia During Sedated Endoscopy in High-Risk Obstructive Sleep Apnea Patients), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07307560 narecruitingnot on this map

High-Flow Nasal Cannula for Preventing Hypoxia During Sedated Endoscopy in High-Risk Obstructive Sleep Apnea Patients: A Multicenter Randomized Trial

TypeinterventionalSponsorZhejiang UniversityRan2025 to 2026Enrolled600ConditionsHypoxia, Esophageal Cancer, Gastric Cancer (Diagnosis), Obstructive Sleep Apnea (OSA)ArmsHigh-flow nasal cannula Group, Regular Nasal Cannula
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Mingxia XuDepartment of Anesthesiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Saiheng XiangDepartment of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Yongmin PiDepartment of Anesthesiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Yuhuan ZhuDepartment of Anesthesiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Xiaotong ChenDepartment of Anesthesiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Qinqin YangDepartment of Anesthesiology, Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou, China.
Huawei WuDepartment of Anesthesiology, Quzhou Qujiang District Hospital, Quzhou, China.
Kan DengDepartment of Anesthesiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Yi YinDepartment of Anesthesiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Diansan SuDepartment of Anesthesiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHypoxemia is the most common adverse event during sedated gastrointestinal endoscopy. Patients with high obstructive sleep apnea (OSA) risk (STOP-Bang ≥5) are susceptible due to sedation-induced loss of upper airway tone exacerbating airway collapsibility. Although high-flow nasal cannula (HFNC) benefits general at-risk populations, its efficacy in this specific cohort remains uncertain, as its mild positive pressure falls far below therapeutic continuous positive airway pressure levels for moderate-to-severe OSA, questioning its ability to stent the collapsible airway. Our prior proof-of-concept study in this cohort observed a 5% incidence of hypoxemia with HFNC, confirming feasibility and safety and justifying this confirmatory trial.

methodsThis prospective, multicenter, randomized controlled single-blind trial will enroll 600 adults (STOP-Bang score ≥5) undergoing elective sedated gastroenteroscopy across three centers. Participants will be 1:1 randomized (stratified by center) to HFNC (30 L/min pre-oxygenation, 60 L/min post-induction) or conventional nasal cannula (6 L/min). Both groups receive standardized propofol-alfentanil sedation. The primary outcome is the proportion of patients with at least one episode of hypoxemia (SpO DISCUSSION: This trial will provide definitive evidence on HFNC's efficacy in high-risk OSA patients, addressing whether it can overcome pressure limitations to prevent hypoxemia. Results are expected to inform sedation management guidelines, establish a new standard of care for this subgroup, and enhance procedural safety.

trial registrationThe trial was registered at the ClinicalTrials.gov on 14 December 2025 (NCT07307560).

Indexed as

CannulaEndoscopy, GastrointestinalHypoxiaOxygen Inhalation TherapySleep Apnea, ObstructiveAdultFemaleHumansMaleProcedural SedationProspective StudiesSingle-Blind Methodgastrointestinal endoscopyHigh-flow nasal cannulahypoxemiaobstructive sleep apnoeasedated

Identifiers

PMID42504139
PMCPMC13417645

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.