Pulmonary Procedures |

Use of Naso-Tracheal Oxygen Catheter During Bronchoscopy in Patients With High Oxygen Demand FREE TO VIEW

Justin Thomas, MD; Michael Galloway, RRT; Ali Musani, MD
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National Jewish Health, Denver, CO

Chest. 2013;144(4_MeetingAbstracts):802A. doi:10.1378/chest.1694394
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SESSION TITLE: Bronchoscopy and Interventional Procedures Posters I

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 30, 2013 at 01:30 PM - 02:30 PM

PURPOSE: Flexible bronchoscopy is often complicated by hypoxia and frequently results in early termination or prolongation of the procedure in patients with preexisting pulmonary diseases. Infrequently hypoxia can lead to cardiac arrhythmias, respiratory failure and death. The insertion of a naso-tracheal oxygen catheter (NTOC) to the mid trachea by bronchoscopic guidance can reduce the complication of hypoxia during bronchoscopy.

METHODS: In our retrospective analysis of 25 bronchoscopies (24 patients) done for various reasons where patients experienced hypoxia not responsive to upward titration of oxygen via nasal cannula, an NTOC (Air-Life™ Oxygen Catheter) was used. The catheter was introduced through the nares and guided into the trachea under direct bronchoscopic visualization. Once the NTOC was in place, nasal cannula was removed.

RESULTS: NTOC improved the pulse oximetry saturations to 93-100% (mean 96.2%) during 100% of the bronchoscopies (25/25) from a nadir mean of 82.6%. After NTOC placement, there was a subsequent down titration of oxygen from mean 11.36 L/min with nasal cannula oxygen to 3.76 L/min with NTOC. None of the patients had complications from bronchoscopy or from insertion of nasal oxygen catheter. No carbon dioxide retention was noted. Average NTOC insertion time was less than one minute.

CONCLUSIONS: Insertion of a NTOC in the trachea by direct bronchoscopic visualization in severely hypoxic patients during bronchoscopy or preemptively at the beginning of bronchoscopy is a safe way to improve or maintain oxygenation during bronchoscopy and may facilitate shorter bronchoscopy times.

CLINICAL IMPLICATIONS: The use of a NTOC during bronchoscopy can diminish hypoxia during the procedure and, as a result, may decrease procedure times and complications.

DISCLOSURE: The following authors have nothing to disclose: Justin Thomas, Michael Galloway, Ali Musani

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