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Oxyshield™ - Guidelines

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The key guidelines are as follows:

 

A) BSG Safety and sedation during endoscopic procedures

 

Oxygen should be given to all sedated patients and selected unsedated patients throughout the procedure and recovery period.

 

Clinical Monitoring, pre-oxgenation and supplemental oxygen

 

Preoxygenation with oxygen enriched air (2 litres per minute) is safe even in chronic obstructive pulmonary disease and greatly diminishes or prevents hypoxaemia.  This should be used routinely in all at-risk patients.

 

B) European guidelines

 

S3 Guideline: Sedation for gastrointestinal endoscopy 2008, Riphaus A et al. Endoscopy Journal 2009; 41: 787–815

 

4.3 Protection of vital functions

 

Recommendation: Sedated patients should receive oxygen prophylactically

 

Prophylactic oxygen administration can significantly reduce the frequency of hypoxemic events.

 

ST depression can be significantly reduced by oxygen supplementation during endoscopy

 

C) US Guidelines and clinical papers

 

1) Endoscpoic sedation; Preparing for the future. Cohen et al; Gastrointestinal Endoscopy Clin N Am 18 (2008) 651–663

 

The findings of this study indicated that the use of supplemental oxygen reduced the risk of significant cardiopulmonary events during EGD (OR: 0.61; 95% CI, 0.42–0.90) but not during colonoscopy.

 

Routine administration of supplemental oxygen during moderate and deep sedation is endorsed by the ASA and the ASGE.

 

2) Guidelines for conscious sedation and monitoring during gastrointestinal endoscopy. American Society For Gastrointestinal Endoscopy VOLUME 58,NO . 3,2003 Gastrointestinal Endoscopy

 

Supplemental oxygen administration has been shown to reduce the magnitude of oxygen desaturation when given during endoscopic procedures.

 

3) Supplemental oxygen during moderate sedation and the occurrence of clinically significant desaturation during endoscopic procedures. Rozario L, Sloper D, Sheridan MJ.Gastroenterology Laboratory, Inova Fairfax Hospital, Falls Church, Virginia 22042, USA.

 

The results of this study support the routine use of supplemental oxygen (2 liters/minute) during endoscopic procedures to prevent desaturation. On the basis of the study data, it is recommended that patients undergoing endoscopy with moderate sedation, who meet the inclusion and exclusion criteria of this study, receive supplemental oxygen (2 L/min). Routine incorporation of this recommendation in hospital policies will ensure that patients routinely receive this preventive measure: supplemental oxygen during moderate sedation and the occurrence of clinically significant desaturation during endoscopic procedures.

 
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