• Respiratory care · Jun 2023

    Observational Study

    Changes in Peripheral Oxygen Saturation in Hospitalized Subjects During Fiberoptic Bronchoscopy: High-Flow Nasal Cannula versus Standard Oxygen Therapy.

    • Pedro Pablo Arias-Sanchez, Gabriela Ledesma, Johana Cobos, Hugo Tirape, Betzy Jaramillo, Jeimmy Ruiz, Lucia Pacheco, Juan Martinez, Remigio Maldonado, Luis Andrade, Omar Bustamante, and Hernan Aguirre-Bermeo.
    • Intermediate Care Unit, Hospital Vicente Corral Moscoso, Cuenca, Ecuador.
    • Respir Care. 2023 Jun 1; 68 (6): 727733727-733.

    BackgroundHypoxemia is a relatively common complication in stable patients during fiberoptic bronchoscopy (FOB). To prevent this complication, high-flow nasal cannula (HFNC) has been described as an alternative to standard oxygen therapy. However, the advantages of HFNC over standard oxygen therapy in acute care patients receiving supplemental oxygen before FOB performed with an oral approach are unknown.MethodsWe conducted an observational study that involved subjects with a presumptive diagnosis of pneumonia and a clinical indication for a bronchial aspirate sample. The type of oxygen support (standard oxygen therapy vs HFNC) was selected according to availability. The oxygen flow in the HFNC group was 60 L/min. In both groups, the FIO2 was set at 0.40. Hemodynamic, respiratory dynamics, and gas exchange data were collected at baseline, before, during, and 24 h after FOB.ResultsForty subjects were included, 20 in each group (HFNC and standard oxygen therapy). The study was performed on day 5 of hospitalization in the HFNC group and on day 4 in the standard oxygen therapy group (P = .10). No significant between-group differences in baseline characteristics were observed. HFNC vs standard oxygen therapy was associated with a smaller decrease in SpO2 levels during the procedure (94% vs 90%; P = .040, respectively) and with less variation between the last SpO2 measured before FOB and the lowest SpO2 during FOB (Δ SpO2 ): 2% versus 4.5% (P = .01, respectively).ConclusionsIn acute subjects who required oxygen support before FOB, the use of HFNC during FOB with an oral approach was associated with a smaller decrease in SpO2 and lower Δ SpO2 compared with standard oxygen therapy.Copyright © 2023 by Daedalus Enterprises.

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