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Do all patients require supplemental oxygen during flexible bronchoscopy?
1Department of Cardio-Respiratory Medicine, Hope Hospital, Salford, Manchester, UK. andmarkj@hotmail.com
Chest
|June 16, 2001
Summary
Supplemental oxygen is not always needed during flexible bronchoscopy, especially for patients with higher FEV1. Monitoring oxygen saturation is crucial for all patients undergoing the procedure.
Area of Science:
- Pulmonology
- Respiratory Medicine
- Critical Care
Background:
- Supplemental oxygen use during flexible bronchoscopy varies, with some centers providing it routinely and others only when oxygen saturation drops below 90%.
- The impact of midazolam sedation on oxygenation during this procedure is also a consideration.
Purpose of the Study:
- To evaluate the necessity of supplemental oxygen during flexible bronchoscopy.
- To determine the effect of intravenous midazolam on oxygenation in patients with a known forced expiratory volume in 1 second (FEV(1)).
Main Methods:
- Prospective data collection on arterial oxygen saturation (SaO(2)) during flexible bronchoscopy procedures.
- Analysis of 1,051 procedures in patients with known FEV(1) who were not on supplemental oxygen prior to the procedure.
Main Results:
- 14.4% of patients required supplemental oxygen during or after bronchoscopy, and 9.6% experienced transient desaturation.
- A lower FEV(1) correlated with a higher risk of desaturation and need for oxygen (p < 0.0001).
- Midazolam sedation did not significantly impact the likelihood of desaturation (p = 0.204).
Conclusions:
- Pulse oximetry monitoring is recommended for all patients during flexible bronchoscopy.
- Desaturation can occur irrespective of FEV(1) or sedation.
- Routine oxygen supplementation may not be necessary for most patients, particularly those with FEV(1) > 1 L.