Optimal flow of high-flow nasal cannula oxygenation to prevent desaturation during sedation for bronchoscopy: a randomized controlled study.

IF 3.3 3区医学 Q2 RESPIRATORY SYSTEM Therapeutic Advances in Respiratory Disease Pub Date : 2024-01-01 DOI:10.1177/17534666241246637

Wen Zhang, Xiaohong Yuan, Yajian Shen, Jiangling Wang, Kangjie Xie, Xinzhong Chen

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Abstract

Background: Although high-flow nasal cannula (HFNC) oxygenation is currently recommended to prevent desaturation during sedation for bronchoscopy, there is no consensus on an optimal flow rate.

Objective: To determine the optimal oxygen flow rate for HFNC to effectively prevent desaturation during sedation for bronchoscopy.

Design: Prospective, randomized, and controlled study.

Methods: Patients (n = 240) scheduled for bronchoscopy were randomized to receive HFNC with propofol sedation (fraction of inspired oxygen, 100%) at one of six flow rates of 10, 20, 30, 40, 50, and 60 L/min, designated as groups 1-6, respectively.

Results: The incidence of desaturation significantly decreased by increasing the oxygen flow rate (42.5%, 17.5%, 15%, 10%, 2.5%, and 0% for groups 1-6, respectively, p < 0.0001). The optimal oxygen flow rate for HFNC determined by probit regression to effectively prevent desaturation in 95% of patients was 43.20 (95% confidence interval, 36.43-55.96) L/min. The requirement for airway intervention was significantly decreased by increasing the oxygen flow rate.

Conclusion: An HFNC flow rate of 50-60 L/min is recommended to prevent desaturation during sedation for bronchoscopy.

Registration: NCT05298319 at ClinicalTrials.gov.

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预防支气管镜检查镇静过程中出现失饱和的最佳高流量鼻插管吸氧：随机对照研究。

背景：尽管目前推荐使用高流量鼻插管（HFNC）吸氧来防止支气管镜检查镇静期间出现失饱和，但对于最佳流速尚未达成共识：确定 HFNC 的最佳氧流量，以有效防止支气管镜检查镇静过程中出现失饱和：设计：前瞻性、随机对照研究：计划接受支气管镜检查的患者（n = 240）被随机分配到接受异丙酚镇静（吸入氧饱和度为 100%）的 HFNC，六种流速分别为 10、20、30、40、50 和 60 L/min（1-6 组）：结果：随着氧气流速的增加，饱和度降低的发生率明显降低（1-6 组分别为 42.5%、17.5%、15%、10%、2.5% 和 0%，p 结论：50-60 L/min 的高频核磁共振（HFNC）流速可减少饱和度降低的发生率：建议使用 50-60 升/分钟的 HFNC 流速来防止支气管镜检查镇静期间出现不饱和现象：注册：ClinicalTrials.gov 上的 NCT05298319。

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来源期刊

Therapeutic Advances in Respiratory Disease RESPIRATORY SYSTEM-

CiteScore

6.90

自引率

0.00%

发文量

审稿时长

15 weeks

期刊介绍： Therapeutic Advances in Respiratory Disease delivers the highest quality peer-reviewed articles, reviews, and scholarly comment on pioneering efforts and innovative studies across all areas of respiratory disease.