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Comparison of High-Flow Nasal Cannula and Conventional Oxygen Therapy for High Risk Patients During Bronchoscopy
Annals of the American Thoracic Society
|March 19, 2025
Summary
High-flow nasal cannula (HFNC) therapy significantly reduces desaturation and interruptions during nasal bronchoscopy in high-risk patients. This oxygen delivery method improves patient outcomes and procedural efficiency in complex cases.
Area of Science:
- Respiratory Medicine
- Critical Care
- Pulmonology
Background:
- High-flow nasal cannula (HFNC) therapy is increasingly used during endoscopic procedures.
- Its effectiveness in high-risk patients undergoing nasal bronchoscopy remains unclear.
Purpose of the Study:
- To compare HFNC with conventional oxygen therapy (COT) in high-risk patients during nasal bronchoscopy.
- To evaluate the impact on desaturation, procedural interruptions, and treatment escalation.
Main Methods:
- Multicenter randomized controlled trial (RCT) involving patients at high risk for desaturation.
- Random assignment to HFNC or COT with continuous monitoring of vital signs, SpO2, and PtCO2.
- Key outcomes included desaturation events, examination interruptions, and treatment escalation.
Main Results:
- HFNC significantly reduced desaturation occurrence (34.7% vs. 61.4%, p=0.016) and examination interruptions (26.4% vs. 58.6%, p<0.001).
- Treatment escalation was less frequent with HFNC (30.6% vs. 57.1%, p=0.001).
- HFNC maintained higher SpO2 and lower PtCO2 levels during the procedure.
Conclusions:
- HFNC therapy is superior to COT in reducing desaturation and procedural complications during nasal bronchoscopy for high-risk patients.
- HFNC improves safety and efficiency in managing patients with airway stenosis undergoing bronchoscopy.
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