Search for a command to run...
Introduction. Hypoxemia is a common and potentiallyserious complication during endoscopic procedures performed under sedation, particularly in patientswith obesity, chronic respiratory disease, orreduced pulmonary reserve. The high flow nasal cannula(HFNC) delivers heated and humidified oxygenat high flow rates with a stable fraction of inspiredoxygen (FiO2), thereby reducing desaturation andimproving oxygenation compared with conventionaloxygen delivery methods.Aim. This review evaluated the efficacy of HFNC inpreventing hypoxemia during gastrointestinal endoscopy,bronchoscopy, and endoscopic retrograde cholangiopancreatography(ERCP) under sedation, focusingon clinical applicability and patient safety.Methods. A systematic search of PubMed, Web ofScience, and Scopus (2015–2025) identified Englishlanguage studies, including randomized trials, comparativeand observational studies, and reviews. Predefinedinclusion criteria were applied, and outcomesincluded the incidence of hypoxemia, minimum SpO2,and the need for airway interventions.Results. Of 628 records screened, 30 studies met theinclusion criteria (13 randomized trials, 3 prospectivecomparative, 1 observational, 3 retrospective, and 10systematic reviews or meta-analyses). Most confirmedthat HFNC reduces hypoxemia, increases minimumSpO2, and improves ventilation stability comparedwith conventional oxygen therapy. The greatest benefitswere observed among high-risk patients such aselderly, obese, and those with respiratory disease. Optimalflow rates ranged from 50 to 60 L/min, ensuringefficacy, comfort, and safety.Conclusion. HFNC provides effective oxygenationsupport during sedated endoscopic procedures,reducing desaturation and the need for airway interventions.Standardized protocols and further researchon long term outcomes are recommended.