Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Gastroenterol. Sep 14, 2026; 32(34): 118510
Published online Sep 14, 2026. doi: 10.3748/wjg.118510
Cold water infusion enhances image quality in sedated miniprobe endoscopic ultrasonography: A prospective, multicenter, double-blind, randomized trial
Xia-Yu Mao, Ming-Mei Ye, Xiao-Yu Yu, Jiang-Tao Liao, Yang Hu, Min Guo, Bin Zeng, Juan Li, Liu Peng, Wen-Fang Hu, Han Liu, Pan Gong, Yu Long, Xiao-Yan Wang, Li Tian
Xia-Yu Mao, Ming-Mei Ye, Xiao-Yu Yu, Pan Gong, Xiao-Yan Wang, Li Tian, Department of Gastroenterology, The Third Xiangya Hospital of Central South University, Changsha 410013, Hunan Province, China
Jiang-Tao Liao, Juan Li, Department of Gastroenterology, Hunan Provincial People’s Hospital, Changsha 410005, Hunan Province, China
Yang Hu, Liu Peng, Department of Gastroenterology, Affiliated Nanhua Hospital, University of South China, Hengyang 421001, Hunan Province, China
Min Guo, Wen-Fang Hu, Department of Gastroenterology, The First People’s Hospital of Changde, Changde 415000, Hunan Province, China
Bin Zeng, Han Liu, Department of Gastroenterology, The First Affiliated Hospital of South China University, Hengyang 421001, Hunan Province, China
Yu Long, Health Management Center, The Third Xiangya Hospital of Central South University, Changsha 410013, Hunan Province, China
Co-first authors: Xia-Yu Mao and Ming-Mei Ye.
Author contributions: Mao XY, Ye MM, and Tian L designed the research study; Yu XY, Liao JT, Hu Y, Guo M, Zeng B, Li J, Peng L, Hu WF, Liu H, Gong P, Long Y, Wang XY, and Tian L performed the research; Mao XY, Ye MM, Tian L, and Gong P analyzed and interpreted the data; Mao XY and Ye MM drafted the manuscript; Tian L, Mao XY, and Ye MM critically revised the manuscript; Mao XY and Ye MM performed statistical analysis as co-first authors; Tian L provided administrative, technical, or material support, and supervised the study. All authors read and approved the final manuscript.
Institutional review board statement: The study was approved by the Ethical Committee of the Third Xiangya Hospital of Central South University, No. 22177.
Clinical trial registration statement: The study has been registered at ClinicalTrials.gov, No. NCT05454475.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Data sharing statement: Technical appendix, statistical code and dataset available from the corresponding author. Participants gave informed consent for data sharing.
Corresponding author: Li Tian, MD, PhD, Department of Gastroenterology, The Third Xiangya Hospital of Central South University, No. 138 Tongzipo Road, Yuelu District, Changsha 410013, Hunan Province, China.
tianlixy3@csu.edu.cn
Received: January 5, 2026
Revised: March 10, 2026
Accepted: April 10, 2026
Published online: September 14, 2026
Processing time: 227 Days and 0.6 Hours
BACKGROUND
Miniprobe endoscopic ultrasonography (mEUS) plays an increasingly significant role in gastrointestinal (GI) lesions. Previous studies showed the water temperature could affect patients’ GI peristalsis and safety; however, the optimal water temperature for mEUS remains uncertain.
AIM
To evaluate the effects of different infusion water temperatures on image quality, diagnostic accuracy, safety, and comfort during sedated mEUS.
METHODS
This prospective, multicenter, double-blind, randomized controlled trial was conducted at five tertiary hospitals. A total of 240 patients were randomly assigned to cold water group (CG, 6-10 °C), warm water group (WG, 20-24 °C), or hot water group (HG, 35-39 °C) groups. Primary outcome was image quality. Secondary outcomes included diagnostic accuracy, peristaltic grade, haemodynamics, comfort and satisfaction scores, and adverse events. χ2 test, ANOVA, and Kruskal-Wallis test were used for comparisons.
RESULTS
Between June 2022 and March 2024, 240 patients were randomly assigned to the three groups. The percentage of high-quality images (score 5) was significantly higher in the CG than in the WG and HG (88.8% vs 75.0% vs 65.0%, P = 0.002). Diagnostic accuracy was numerically higher in the CG than in the WG and HG (97.0% vs 81.5% vs 81.1%). Peristalsis scores were significantly lower in the CG compared to both the WG and HG (P < 0.001). No severe adverse events occurred. Comfort and satisfaction scores did not differ significantly among the groups.
CONCLUSION
Cold water infusion reduces GI peristalsis and improves image quality with excellent safety. Cold water (6-10 °C) may be the optimal temperature for sedated mEUS.
Core Tip: Cold water (6-10 °C) significantly improves image quality and suppresses gastrointestinal peristalsis during sedated miniprobe endoscopic ultrasonography. Our multicenter trial showed higher rates of high-quality images (88.8% vs 75.0% vs 65.0%) and numerically higher diagnostic accuracy with cold water compared with warm (20-24 °C) and hot (35-39 °C) water. With excellent safety and comparable comfort, cold water may be the optimal temperature choice for miniprobe endoscopic ultrasonography under sedation.
