Use of Non-Invasive Positive Pressure Ventilation in Patients With Severe Obesity Undergoing Upper Endoscopy Procedures

Patients being evaluated for bariatric surgery often undergo preoperative upper endoscopy.
Patients with obesity are at increased risk for sedation related adverse events during
endoscopy. The study evaluated the effect of non-invasive positive pressure ventilation
(NIPPV) to decrease the incidence of desaturation in patients with severe obesity undergoing
upper endoscopy. The study was a randomized controlled trial that assessed the effectiveness
of NIPPV in patients undergoing upper endoscopy. Patients were randomized into experimental
group NIPPV or control group. Primary endpoints were desaturation events (SpO2 <=94%) and
desaturation events requiring intervention (SpO2<=90%). A secondary endpoint was the use of
NIPPV to rescue patients who developed a clinically significant desaturation event.

Inclusion Criteria:

- Weight loss surgery patients undergoing preoperative upper endoscopy

- BMI 40-60

Exclusion Criteria:

- Pregnant patients

- Previous weight loss surgery or stomach surgery

- BMI > 60 and BMI < 40

- Active smokers

- Patients with a history of recent URTI (Upper Respiratory Tract Infection) within the
preceding 2 weeks

- Lung disease, COPD asthma, cystic fibrosis, sarcoidosis

- Baseline O2 saturation less than or equal to 94%

- Exclude substance abusers (active alcohol abuse, benzodiazepine abuse, and active
illicit drug use)