Assessing the Feasibility and Cost of High-Flow Nasal Oxygenation in Gastrointestinal Procedures

The purpose of this project was to assess the feasibility and cost of high-flow nasal oxygenation therapy for gastrointestinal procedures in an endoscopy clinic. An observational, convenience sample design was used to evaluate multiple variables, including the frequency of high-flow nasal oxygenation therapy utilization, clinician satisfaction, setup duration, airway interventions, complications, procedure length, and alternative airway device use. A cost analysis compared high-flow nasal oxygenation therapy to other commonly used airway devices at this site. High-flow nasal oxygenation therapy was frequently utilized and received high clinician satisfaction ratings. The median length of gastrointestinal procedures with high-flow nasal oxygenation therapy was 30 minutes, with a median setup time of 2 minutes between cases. Although high flow nasal oxygenation therapy had a higher fixed cost than traditional airway devices, the cost was comparable to that of a nasal ventilation mask. Despite the initial expense, high-flow nasal oxygenation therapy’s rapid setup and clinician preference suggest it is feasible in the endoscopy setting. The high fixed cost may be offset by increased patient volumes and sustained device utilization.