Respiratory safety and resource utilization in ERCP: a comparative study of high-flow nasal oxygen, conventional mask, and general anesthesia in high-risk populations

The study compared three oxygenation methods during endoscopic retrograde cholangiopancreatography (ERCP) in 194 patients: high-flow nasal oxygen (HFNO), conventional simple mask (SM), and general anesthesia (GA). Desaturation (SpO₂ < 92%) occurred in 59.7% of SM patients, while in HFNO and GA groups it was 0%. In elderly patients (≥65 years), desaturation in the SM group reached 81%, whereas in HFNO and GA it was 0%. Minimum SpO₂ was lowest in the SM group (90%) compared to HFNO (99%) and GA (99%). Airway interventions were required in 31.4% of SM patients and only 5.4% of HFNO patients. Oxygen consumption was highest with HFNO (500 L) compared to SM (175 L) and GA (34.5 L). The study concluded that HFNO provides a high level of respiratory stability comparable to GA even in high-risk patients.