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High-Flow Oxygen Does Not Improve Oxygenation during Rigid Medical Thoracoscopy
Andrei M Darie1,2, Leticia Grize3, Kathleen Jahn1
1Clinic of Respiratory Medicine, University Hospital Basel, Basel, Switzerland.
Introduction:
The sedation required for rigid medical thoracoscopy may be associated with hypoventilation and intermittent hypoxaemia. High-flow oxygen administration has been shown to decrease hypoxaemia during sedation for flexible bronchoscopy, a procedure using similar sedation protocols to medical thoracoscopy.
Methods:
An investigator-initiated randomised controlled trial to compare conventional oxygen (starting at 4 L/min) to high-flow nasal oxygen (starting rate 60 L/min and fraction of oxygen 0.6) during sedation for medical thoracoscopy. The mean nadir oxygen saturation (SpO2) during the procedure was the primary endpoint.
Results:
Between February 2022 and June 2023, 36 patients were randomised to either conventional oxygen (n = 20) or high-flow oxygen (n = 16). The majority of participants (20/36, 55.6%) were male, and the mean age was 75.4 ± 10.4 years. The nadir SpO2 was 88.3% using high flow as compared to 85.0% for conventional oxygen (p = 0.20). The average SpO2 (96.3% vs. 96.2%, p = 0.81) was similar between groups. There was a tendency towards a higher peak PtcCO2 in the conventional oxygen group (49.6 mm Hg vs. 55.5 mm Hg, p = 0.13).
Conclusion:
Oxygen supplementation using nasal high flow provides similar SpO2 to conventional nasal oxygen during sedation for rigid medical thoracoscopy.
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