Comparison of different flow rates of high-flow nasal cannula oxygen therapy for fiberoptic broncho-scopy
Objective To evaluate the safety and efficacy of high-flow nasal cannula(HFNC)oxy-gen therapy combined with midazolam and high-dose alfentanil for fiberoptic bronchoscopy under deep seda-tion.Methods A total of 160 patients,88 males and 72 females,aged 18-64 years,BMI 15-36 kg/m2,ASA physical status Ⅰ or Ⅱ,who scheduled for painless fiberoptic bronchoscopy were included.Patients were divided into four groups using random number table method:the control group(group C,n=38),group HF25(n=37),group HF45(n=39)and group HF65(n=37).Group C were offered conven-tional nasal catheter oxygen at 5 L/min,and group HF25,group HF45 and group HF65 were offered HFNC oxygen therapy at 25 L/min,45 L/min and 65 L/min,respectively.All the patients were induced by seda-tion regimes with midazolam 0.05 mg/kg and alfentanil(17.5-30.0 μg/kg),and routine fiberoptic bron-choscopy was performed after the target depth of deep sedation was reached.The lowest SpO2 during the op-eration,the incidence of hypoxia during the operation,the score of cough VAS and the incidence of cough,the use and dosage of urapidil,the painful memory during the operation,and the willingness to undergo re-examination were recorded.The occurrence of adverse reactions such as nausea,vomiting,lethargy,dizzi-ness,and discomfort with oxygen inhalation airflow were recorded.Results Compared with group C,the lowest SpO2 during the operation in groups HF45 and HF65 were significantly increased and the incidence of hypoxia were significantly decreased(P＜0.05).Compared with group HF25,the lowest SpO2 during the operation in group HF65 was significantly increased(P＜0.05).Compared with group HF65,the incidence of discomfort with oxygen inhalation airflow in groups C,HF25,and HF45 was significantly re-duced(P＜0.05).There were no significant differences in the VAS score and incidence of coughing,the use and dosage of urapidil,intraoperative painful memory and willingness to undergo re-examination,nause-a,vomiting,lethargy,dizziness,and other adverse reactions among the four groups.Conclusion 45 L/min or 65 L/min flow HFNC oxygen therapy can significantly increase the lowest SpO2 and reduce the incidence of hypoxia in fiberoptic bronchoscopy patients under deep sedation with midazolam and high-dose alfentanil during operation.Moreover,patients are less uncomfortable with the airflow of 45 L/min HFNC oxygen therapy.
万方数据
维普
