{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T11:16:01Z","timestamp":1790162161336,"version":"4.1.0"},"reference-count":18,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:00:00Z","timestamp":1788480000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:00:00Z","timestamp":1788480000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100022617","name":"Fisher and Paykel Healthcare","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100022617","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["DEN Open"],"published-print":{"date-parts":[[2027,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Nasal high flow (NHF) improves oxygenation, reduces the work of breathing, and stabilizes ventilation. In endoscopic retrograde cholangiopancreatography (ERCP) under dexmedetomidine\u2010based sedation, opioids are often required but increase the risk of respiratory depression and delayed recovery. This study tested the hypothesis that NHF therapy, compared with low\u2010flow oxygen (LFO), may reduce opioid requirements during ERCP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This open\u2010label, single\u2010center, randomized controlled trial enrolled patients undergoing ERCP under dexmedetomidine\u2010based sedation. Patients were randomized to NHF or LFO. Sedation used dexmedetomidine, midazolam and pethidine with a standardized protocol. The primary endpoint was total pethidine dose. Secondary endpoints included transcutaneous carbon dioxide (TcCO\n                      <jats:sub>2<\/jats:sub>\n                      ), oxygenation\u2010perfusion parameters, processed electroencephalography (EEG) parameters, sedative doses, and sedation depth.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Enrollment ended early at a total of 94 of the planned 118 patients due to slow recruitment (NHF 47, LFO 47). Poisson regression demonstrated reduced opioid requirements with NHF (incidence rate ratio 0.77, 95% confidence interval, 0.62\u20130.96,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.023). The total pethidine dose was lower in the NHF group (medians 43.75\u00a0mg vs. 70.00\u00a0mg,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.004). The TcCO\n                      <jats:sub>2<\/jats:sub>\n                      and oxygenation\u2010perfusion parameters were comparable between groups. EEG tests showed lower patient state index and electromyographic activity in the NHF group, indicating deeper sedation. No adverse events attributable to interventions were observed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>NHF reduced opioid requirements while maintaining oxygenation, ventilation, and sedation during ERCP. The ability of NHF to provide respiratory support, ensure adequate oxygenation, and allow monitoring of breathing makes it a promising modality during procedural sedation; however, further multi\u2010center studies are needed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>072210047 [jRCTs]<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/deo2.70421","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T07:52:39Z","timestamp":1788508359000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Respiratory Support With Nasal High Flow Reduces Opioid Requirements During Endoscopic Retrograde Cholangiopancreatography"],"prefix":"10.1002","volume":"7","author":[{"given":"Tomotaka","family":"Mori","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology Nagasaki University Graduate School of Biomedical Sciences  Nagasaki Japan"},{"name":"Department of Gastroenterology and Hepatology Japanese Red Cross, Nagasaki Genbaku Hospital  Nagasaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takao","family":"Ayuse","sequence":"additional","affiliation":[{"name":"Clinical Research Center Nagasaki University Hospital  Nagasaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuntaro","family":"Sato","sequence":"additional","affiliation":[{"name":"Clinical Research Center Nagasaki University Hospital  Nagasaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taiga","family":"Ichinomiya","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine Nagasaki University Graduate School of Biomedical Sciences  Nagasaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rintaro","family":"Yano","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine Nagasaki University Graduate School of Biomedical Sciences  Nagasaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akane","family":"Shimakura","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Nagasaki University Graduate School of Biomedical Sciences  Nagasaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhiko","family":"Nakao","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Nagasaki University Graduate School of Biomedical Sciences  Nagasaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kosuke","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Nagasaki University Graduate School of Biomedical Sciences  Nagasaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masanori","family":"Fukushima","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Nagasaki University Graduate School of Biomedical Sciences  Nagasaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masafumi","family":"Haraguchi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Nagasaki University Graduate School of Biomedical Sciences  Nagasaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryu","family":"Sasaki","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Nagasaki University Graduate School of Biomedical Sciences  Nagasaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eisuke","family":"Ozawa","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Nagasaki University Graduate School of Biomedical Sciences  Nagasaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Miuma","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Nagasaki University Graduate School of Biomedical Sciences  Nagasaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stanislav","family":"Tatkov","sequence":"additional","affiliation":[{"name":"Fisher &amp; 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