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A new reliable acoustic respiratory monitoring technology during upper gastrointestinal tract therapeutic endoscopy with CO2 insufflation

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Abstract

Previous studies documented the effectiveness and benefits of capnography monitoring during propofol-based sedation for colonoscopy to reduce the incidence of hypoxemia. However, the performance of capnography during longer duration endoscopic therapy of upper gastrointestinal tract cancers under CO2 insufflation it is not well known. In this study, we compare a new device with acoustic monitoring technology to standard capnography monitoring. We retrospectively analyzed 49 patients who underwent endoscopic resection of early upper gastrointestinal tract cancer between December 2013 and October 2014. All 49 patients were monitored using both acoustic monitoring technology and standard capnography. We investigated the duration of the periods with unmeasurable respiratory rate during the overall procedure. When comparing standard capnography monitoring to the new acoustic monitoring technology, the ratio of the unmeasurable time was significantly lower in RRa (36.9% vs. 21.6%, p < 0.01). The ratio of unmeasurable respiratory rate by capnography was strongly correlated to the ratio of unmeasurable PetCO2 level by capnography (R2 = 0.847). There were no severe events or adverse events (grade 2 or more) during all 49 procedures. The acoustic monitoring technology provides a more reliable respiratory monitoring when compared to standard capnography during endoscopic resection of upper gastrointestinal tract cancers under CO2 insufflation, even if the procedures were prolonged and complex.

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Acknowledgements

We would like to express my deepest gratitude to Dr Victor Ciofoaia for writing support and valuable suggestions for my study.

Funding

This work was supported in part by the National Cancer Center Research and Development Fund (25-A-12, 28-K-1, and 29-A-13) to Dr Saito.

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Authors and Affiliations

Authors

Contributions

HT, YK, IO and YS Study concept and design. HT, YK, IO, MS, MY, SA, SN, HS, SY, and YS Acquisition of data. HT, YK and IO Analysis and interpretation of data. Drafting of the manuscript; HT and YK. Critical revision of the manuscript for important intellectual content; all the authors. HT Statistical analysis. YS Obtained funding. YK, IO and YS Study supervision.

Corresponding author

Correspondence to Hiroyuki Takamaru.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional committee (institutional review board of the National Cancer Center Hospital; IRB number: 2016-447) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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10877_2020_547_MOESM1_ESM.pdf

Three panels show the monitoring of the representative patient (patient 8). Upper panel shows PetCO2, the middle panel is respiratory rate measured by capnography and the lower panel is respiratory rate measured by RRa (acoustic monitoring technology). Supplementary file1 (PDF 147 kb)

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Takamaru, H., Kawaguchi, Y., Oda, I. et al. A new reliable acoustic respiratory monitoring technology during upper gastrointestinal tract therapeutic endoscopy with CO2 insufflation. J Clin Monit Comput 35, 877–884 (2021). https://doi.org/10.1007/s10877-020-00547-2

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  • DOI: https://doi.org/10.1007/s10877-020-00547-2

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