Abstract / Description
BackgroundWomen with cardiovascular disease undergoing cesarean delivery under neuraxial anesthesia are vulnerable to perioperative hypoxemia, particularly during sedation after fetal delivery. We compared high-flow nasal cannula oxygen (HFNC) with Venturi facemask oxygen in this setting.MethodsIn this prospective single-blind randomized controlled trial, 44 women with cardiovascular disease undergoing elective cesarean delivery under neuraxial anesthesia were randomly assigned to HFNC [40 L/min, fraction of inspired oxygen (FiO2) 0.40] or Venturi facemask oxygen (10 L/min, FiO2 0.40). Remimazolam sedation was initiated 5 min after fetal delivery. The primary outcome was maternal arterial partial pressure of oxygen (PaO2) measured 10 min after achievement of the target sedation level. Secondary outcomes included perioperative oxygenation and ventilation variables, hemodynamic variables, airway or oxygenation-related interventions, maternal recovery outcomes, neonatal outcomes, postoperative biomarkers, and tolerance to the oxygen delivery device. Between-group comparisons were performed using appropriate parametric or non-parametric tests, and effect estimates were reported with 95% confidence intervals (CIs).ResultsAll 44 randomized participants were included in the final analysis. During sedation, PaO2 was significantly higher in the HFNC group than in the facemask group (177.3±40.9 vs. 137.5±37.6 mmHg), with an adjusted mean difference of 48.8 mmHg (95% CI: 29.8 to 67.8; P