Oxygen supplementation during awake fibreoptic bronchoscopy in a Nigerian tertiary hospital

Examination of the airway is necessary in a wide variety of conditions. This study was carried out to determine the need for oxygen supplementation during the conduct of flexible fibreoptic bronchoscopy on the awake patient.

A prospective study of consecutive consenting patients requiring awake flexible bronchoscopy between January 2010 and December 2011 using a fibreoptic bronchoscope in the study centre was conducted. With the aid of transcutaneous pulse oximetry, baseline oxygen saturation values were recorded as well as at the various stages of the procedure as well as during brush cytology, washings, biopsy, transbronchial biopsies and transbronchial needle aspirations and 5, 15 and 30 minutes post-procedure. Data was analysed using SPSS 16 and significant values were taken at pd"0.05.

Sixty-seven awake fibreoptic bronchoscopies were performed on 61 patients comprising 38 males and 29 females and a mean age of 51.9 ± 18.9 years. The lowest mean SPO2 of 91.2% was attained during brush cytology. Thirty- four patients (50.7%) had the procedure without oxygen supplementation. Supplemental oxygen was required in all seven patients with a baseline SPO2 of d"92% while it was required in 63.2% of patients with baseline SPO2 of 93- 96%. Baseline oxygen saturation was the most important predictor of the need for oxygen supplementation (p= 0.005).

Routine oxygen supplementation is not mandatory for the safe conduct of flexible bronchoscopy. The baseline oxygen saturation value accurately predicts the need for oxygen administration.