Effect of nasopharyngeal airway on hypoxemia in overweight and obese patients undergoing sedated endoscopy - A randomized trial

Q: What clinical problem does the study address?

Hypoxemia during sedated gastrointestinal endoscopy is frequent, especially in overweight and obese patients. The study evaluates whether a nasopharyngeal airway can prevent it.

Q: How was nasopharyngeal airway compared in the trial?

Nasopharyngeal airway (NA) was compared with standard nasal cannula (NC) in 256 overweight and obese patients undergoing sedated endoscopy.

Q: Which factors predicted hypoxemia risk and how did NA affect outcomes?

Higher STOP-BANG scores independently predicted hypoxemia risk, while NA use independently reduced risk. NA also lowered rates of severe hypoxemia and jaw-thrust maneuvers.

Sep 29, 2026

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Hypoxemia is common during sedated gastrointestinal endoscopy, particularly in overweight and obese patients, but prior evidence on nasopharyngeal airways (NAs) has been unclear. A prospective randomized trial compared NA use with standard nasal cannula oxygenation in 256 participants. NA significantly reduced hypoxemia and severe hypoxemia, decreased the need for jaw-thrust maneuvers, and improved provider satisfaction. Multivariable analysis identified higher STOP-BANG scores as an independent hypoxemia risk factor, while NA use independently protected against it.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages11

Reading Time28 min

AccessFree to download

Summary

Introduction

Background and clinical relevance

Need for preventive strategies

Limitations of existing oxygen therapy approaches

iScience Article Effect of nasopharyngeal airway on hypoxemia in overweight and obese patients undergoing sedated endoscopy: A randomized trial Authors Hai-Ding Zou, Qing Liu, Jie Zhang, ..., Pei Zhou, Cong Luo, Ru-Yi Luo Correspondence [luoruyi@csu.edu.cn](luoruyi@csu.edu.cn) In brief Human physiology; Medical procedure • STOP-BANG score predicts hypoxemia risk in sedated endoscopy • NA decreases rescue interventions and improves provider satisfaction Zou et al., 2026, iScience 29, 114362 January 16, 2026 © 2025 The Author(s) . Published by Elsevier Inc. [https://doi.org/10.1016/j.isci.2025.114362](https://doi.org/10.1016/j.isci.2025.114362) ll iScience ll OPEN ACCESS Article Effect of nasopharyngeal airway on hypoxemiain overweight and obese patients undergoing sedated endoscopy: A randomized trial Hai-Ding Zou,1,2 Qing Liu,1,2 Jie Zhang,3 Yun-Xuan Huang,1,2 Zhao-Lan Hu,1,2 Pei Zhou,1,2 Cong Luo,1,2 and Ru-Yi Luo1,2,4,* 1Department of Anesthesiology, The Second Xiangya Hospital, Central South University, Changsha, China 2Anesthesia Medical Research Center, Central South University, Changsha, China 3Department of Gastroenterology, The Second Xiangya Hospital, Central South University, Changsha, China 4Lead contact *Correspondence: [luoruyi@csu.edu.cn](luoruyi@csu.edu.cn) [https://doi.org/10.1016/j.isci.2025.114362](https://doi.org/10.1016/j.isci.2025.114362) SUMMARY Hypoxemia is common during sedated gastrointestinal endoscopy (SGIE), especially in overweight and obese patients, yet the effectiveness of nasopharyngeal airways (NAs) for prevention remains unclear. This prospective randomized trial compared NA with standard nasal cannula (NC) in 256 overweight and obese patients. Results revealed that the NA group demonstrated a statistically significant reduction of hypoxemia (20/128 [15.6%] vs. 52/128 [40.6%]; p < 0.001) and severe hypoxemia (4/128 [3.1%] vs. 13/128 [10.2%]; p = 0.024), along with fewer jaw-thrust maneuvers (9/128 [7.0%] vs. 34/128 [26.6%]; p < 0.001), compared to the NC group. Multivariable analysis confirmed that higher STOP-BANG scores independently predicted hypoxemia risk, while the use of NA was an independent protective factor (odds ratio, OR, 0.23, 95% CI, 0.12–0.44, p < 0.001) . These findings support using NA to reduce hypoxemia in high-risk patients and underscore the value of STOP-BANG for preoperative screening. INTRODUCTION Overweight and obesity have emerged as significant global public health concerns. As of 2022, approximately 2.5 billion adults aged 18 and older were classified as overweight, with 890 million of them categorized as obese, according to the World Health Organization.1 Notably, it is worth highlighting that China reports the highest number of individuals affected by overweight and obesity worldwide.2 Given this alarming prevalence, obesity is now recognized as a chronic, relapsing, and progressive disease, and its increasing prevalence imposes a considerable burden on healthcare systems due to its strong association with multiple comorbidities and severe complications.3 ,4 For instance, the incidence of gastrointestinal (GI) disorders is notably higher in overweight and obese individuals compared to those with normal body weight.5 ,6 Additionally, it is also important to note that overweight status is closely linked to obstructive sleep apnea (OSA), with a cohort study reporting OSA prevalence rates of 4% in middle-aged men and 2% in middle-aged women.7 Both obesity and OSA are established risk factors for perioperative airway complications, particularly hypoxemia.8 Consequently, overweight and obesity contribute to an increased risk of adverse respiratory events during sedation or anesthesia, especially during procedures like GI endoscopy. In particular, hypoxemia is a critical issue during sedated GI endoscopy (SGIE) due to the combined effects of sedative drugs that depress the respiratory center and relax the air

FAQs

What clinical problem does the study address?

Hypoxemia during sedated gastrointestinal endoscopy is frequent, especially in overweight and obese patients. The study evaluates whether a nasopharyngeal airway can prevent it.

How was nasopharyngeal airway compared in the trial?

Nasopharyngeal airway (NA) was compared with standard nasal cannula (NC) in 256 overweight and obese patients undergoing sedated endoscopy.

Which factors predicted hypoxemia risk and how did NA affect outcomes?

Higher STOP-BANG scores independently predicted hypoxemia risk, while NA use independently reduced risk. NA also lowered rates of severe hypoxemia and jaw-thrust maneuvers.

Sep 29, 2026

Upload by awa