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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.
Respiration; International Review of Thoracic Diseases
|December 1, 2025
Summary
High-flow oxygen therapy during medical thoracoscopy provides similar oxygen saturation levels compared to conventional oxygen. This finding suggests high-flow nasal oxygen is a viable alternative for maintaining oxygenation during this procedure.
Area of Science:
- Pulmonology
- Critical Care Medicine
- Anesthesiology
Background:
- Sedation for rigid medical thoracoscopy can lead to hypoventilation and hypoxemia.
- High-flow oxygen has previously reduced hypoxemia during flexible bronchoscopy.
Purpose of the Study:
- To compare conventional oxygen with high-flow nasal oxygen during sedation for rigid medical thoracoscopy.
- To evaluate the impact on oxygen saturation (SpO2) and carbon dioxide levels.
Main Methods:
- Investigator-initiated randomized controlled trial.
- 36 patients undergoing medical thoracoscopy were randomized.
- Compared conventional oxygen (4 L/min) to high-flow nasal oxygen (60 L/min, 60% O2).
- Primary endpoint: mean nadir SpO2.
Main Results:
- Nadir SpO2 was 88.3% with high-flow vs. 85.0% with conventional oxygen (p=0.20).
- Average SpO2 was similar between groups (96.3% vs. 96.2%, p=0.81).
- A trend towards higher peak end-tidal CO2 was observed in the conventional oxygen group.
Conclusions:
- Nasal high-flow oxygen supplementation offers comparable SpO2 to conventional nasal oxygen during medical thoracoscopy.
- High-flow oxygen is a suitable alternative for oxygenation during this procedure.
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