Abstract
High flow nasal oxygen (HFNO) has been shown to reduce desaturations during flexible bronchoscopy. We evaluated outcomes of HFNO vs. low flow nasal oxygen (LFNO) on intraprocedural hypoxemia, the demand of sedative and reversal medications, post-procedure complications, procedure conversion to general anaesthesia and patient comfort during outpatient standard and EBUS (Endo Bronchial Ultrasound) guided bronchoscopy under conscious sedation.
Highlights
Bronchoscopy is an invaluable diagnostic tool for many lung disorders and a safe procedure with low morbidity and mortality
During the beginning of the Covid 19 pandemic in South Australia, the use of High flow nasal oxygen (HFNO) has been restricted to prevent aerosol transmission. This has led to a change in the practice of HFNO to low flow nasal oxygen (LFNO) during outpatient bronchoscopy by interventional pulmonologists in our unit
The proportion of patients desaturating < 90% was lower in the HFNO group (4 patients, 9.5% versus 17 patients (40%) in the LFNO group (p = 0.001)
Summary
Bronchoscopy is an invaluable diagnostic tool for many lung disorders and a safe procedure with low morbidity and mortality. Deep sedation which can lead to higher rates of desaturation may be beneficial in complex bronchoscopic procedures to increase the diagnostic yield and safety [2]. There is no demonstrated difference in oxygen saturation with transnasal or trans oral bronchoscopic approaches [5] The majority of these desaturation events are transient and do not require specific intervention [6]. High flow nasal oxygen (HFNO) has been shown to reduce desaturations during flexible bronchoscopy. We evaluated outcomes of HFNO vs low flow nasal oxygen (LFNO) on intraprocedural hypoxemia, the demand of sedative and reversal medications, postprocedure complications, procedure conversion to general anaesthesia and patient comfort during outpatient standard and EBUS (Endo Bronchial Ultrasound) guided bronchoscopy under conscious sedation
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