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首页> 外文期刊>Journal of Thoracic Disease >A prospective randomized comparative study of high-flow nasal cannula oxygen and non-invasive ventilation in hypoxemic patients undergoing diagnostic flexible bronchoscopy
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A prospective randomized comparative study of high-flow nasal cannula oxygen and non-invasive ventilation in hypoxemic patients undergoing diagnostic flexible bronchoscopy

机译：低氧血症患者接受柔性支气管镜检查时高流量鼻导管吸氧和无创通气的前瞻性随机对照研究

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Background: Although oxygen supplementation during bronchoscopy in patients with pre-existing hypoxemia is provided, adequacy of oxygenation may not be achieved, resulting in the occurrence of respiratory failure that requires endotracheal tube intubation. The purpose of this study was to compare high-flow nasal cannula (HFNC) with non-invasive ventilation (NIV) in patients with pre-existing hypoxemia undergoing flexible bronchoscopy (FB) on the ability to maintain oxygen saturation during bronchoscopy. Methods: A prospective randomized study was conducted in patients who had hypoxemia [defined as partial pressure of arterial oxygen (PaO 2 ) less than 70 mmHg at room air] and required FB for the diagnosis of abnormal pulmonary lesions. Patients were randomized to receive either HFNC or NIV during FB. The primary outcome was the lowest oxygen saturation level during FB. Results: Fifty-one patients underwent randomization to HFNC (n=26) or NIV (n=25). Baseline characteristics in terms of age, Simplified Acute Physiologic Score II values, and cardiorespiratory parameters were similar in both groups. After receiving HFNC or NIV, oxygen saturation as measured by pulse oximeter (SpO 2 ) increased to greater than 90% in all cases. During FB, although the lowest SpO 2 was similar in both groups, the lowest SpO 2 vs . 12.0%; P=0.057). In patients with baseline PaO 2 2 from preprocedure to the end of FB was less in the NIV group (–13.7 vs . –57.0 mmHg; P=0.019). After FB, the occurrence of SpO 2 Conclusions: In overall, NIV and HFNC provided the similar effectiveness in prevention of hypoxemia in hypoxemic patients undergoing FB. However, in subgroup analysis, NIV provided greater adequacy and stability of oxygenation than HFNC in patients with baseline PaO 2 60 mmHg on ambient air.
机译：背景：尽管已为既往存在低氧血症的患者在支气管镜检查过程中提供了氧气补充，但可能无法实现充氧，导致发生呼吸衰竭，需要进行气管插管。这项研究的目的是比较已有软性支气管镜检查（FB）的低氧血症患者的高流量鼻导管（HFNC）与无创通气（NIV）在支气管镜检查期间维持氧饱和度的能力。方法：对低氧血症（定义为室内空气中动脉血氧分压（PaO 2）小于70 mmHg）且需要FB诊断异常肺部病变的患者进行了一项前瞻性随机研究。患者在FB期间随机接受HFNC或NIV。主要结果是FB期间最低的氧饱和度水平。结果：51例患者接受了HFNC（n = 26）或NIV（n = 25）的随机分组。两组在年龄，简化的急性生理评分II值和心肺参数方面的基线特征相似。在所有情况下，接受HFNC或NIV后，通过脉搏血氧仪（SpO 2）测得的氧饱和度均增至90％以上。在FB期间，尽管两组的最低SpO 2相似，但最低SpO 2与。 12.0％; P ＝ 0.057）。 NIV组从术前到FB结束时基线PaO 2 2的患者较少（–13.7对–57.0 mmHg; P = 0.019）。 FB后发生SpO 2的结论结论：总的来说，NIV和HFNC在预防FB的低氧血症患者中预防低氧血症的作用相似。然而，在亚组分析中，在基线空气中PaO 2 <60 mmHg的患者中，NIV比HFNC提供了更大的充氧和稳定性。

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