Noninvasive ventilation assisted interventional bronchoscopy for hypoxemia patients with central airway stenosis

Abstract

Obsjective: To evaluate the effect and safety of noninvasive ventilation assisted interventional bronchoscopy for hypoxemia patients with central airway stenosis. Methods: 10 cases of patients with hypoxemia central airway stenosis undergoing interventional bronchoscopy , including 5 cases of malignant tumor, 4 cases of bronchial tuberculosis, 1 case wth tracheal stenosis caused by tracheotomy. Patients covered with full mask and then connected with noninvasive ventilator (MAQUET Servo ). Intravenous injection of dezocine and midazolam for sedation and analgesia. With ventilation, bronchoscope went through the nose or mouth for interventional therapy. Results: All cases were treated successfully, including cryotherapy in 8 cases, argon plasma coagulation in 6 cases, balloon dilatation in 5 cases, 2 cases of electrocautery. The procedure time was 58.4 ± 16.4 minutes. The degree of airway stenosis and partial pressure of arterial oxygen were significantly improved after operation. During the argon plasma coagulation in one patient, the SpO2 dropped to 85% as the fraction of inspired oxygen lowered from 1.0 to 0.30, which was transient and not life-threatening. The treatment did not cause serious complications. Sedation produced anterograde amnesia in all patients who expressed an intent to return for repeated interventional bronchoscopy if needed. Conclusion: With the sedation and analgesia, noninvasive ventilation assisted interventional bronchoscopy for hypoxemia patients with central airway stenosis is safe and effective, carries high satisfaction rate.