Nasal Ventilation Mask for Prevention of Upper Airway Obstruction in Patients With Obesity or Obstructive Sleep Apnea

This project aimed to develop and implement a nasal ventilation mask (NVM) guideline to reduce the incidence of airway obstruction in outpatients undergoing endoscopy procedures. An observational design was used to evaluate implementation of an NVM guideline as the oxygen delivery method for this patient population. An evidence-based guideline for NVM use was developed for patients with obstructive sleep apnea (OSA) and/or an elevated body mass index (BMI) above 35 kg/m² undergoing esophagogastroduodenoscopy and/or colonoscopy procedures at an outpatient endoscopy clinic. Patients receiving moderate or deep sedation for esophagogastroduodenoscopy, colonoscopy, or both procedures who had a BMI of at least 35 kg/m² and/or an OSA diagnosis were observed for oxygen desaturation, airway maneuvers, and use of airway adjuncts. Intraoperatively, the group of patients who wore an NVM compared with the group that did not wear an NVM had 3 times greater chance of having at least one occurrence of an oxygen saturation less than or equal to 90% and almost 4 times greater chance of having an oxygen desaturation 5% or greater of baseline oxygen saturation. The NVM offers supportive ventilation and the ability to provide positive pressure assistive breaths, both of which are beneficial to the increasingly obese population.