Arterial blood gases and pneumatic nasal packing in epistaxis

Several clinical studies have associated nasal packing in the treatment of epistaxis with hypoxemia on the basis of a possible nasopulmonary reflex. In 10 patients with epistaxis using a pneumatic nasal pack with central airway that allows a limited airflow, no changes in arterial blood gas tensions were observed. Forced expiratory volume measures were also without significant changes. The results indicate that the nasal packs used do not cause any clinically important alveolar hypoventilation or changes in arterial oxygenation. None of the patients had chronic obstructive pulmonary disease, and it is therefore still important to be aware of hypoxemia as a possible complication to nasal packing, especially in old patients with chronic obstructive pulmonary disease, irrespective of the kind of nasal pack used.