Fibreoptic bronchoscopy in sedated infants facilitated by an airway endoscopy mask.
Fibreoptic bronchoscopy (FB) is frequently associated with a decline in PaO2, whose degree and duration can be substantial especially in infants. The effect of a face mask, which allows the administration of 100% oxygen and continuous positive airway pressure during FB, on the incidence and severity of hypoxaemia was studied in thirty-one consecutive infants. Sedation was provided by intravenous propofol titrated to allow patient comfort. A transient fall in SpO2 <95% was recorded in 6/31 patients during endoscopy of the upper airway (lasting 1.6+/-1.1 min) and in 11/31 patients during endoscopy of the lower airways (lasting 1.4+/-1.1 min). Capillary blood gas analysis before and after endoscopy of the lower airways demonstrated an increase in the PCO2 6.4+/-1.3 to 7.3+/-1.4 kPa (49+/-10 to 56+/-11 mmHg). The risk of hypoxaemia in sedated infants breathing spontaneously is low when 100% oxygen and continuous positive airway pressure are administered during FB
Erb
T
T
Department of Anaesthesia, University Children's Hospital, CH-4005 Basel, Switzerland.
Hammer
J
J
Rutishauser
M
M
Frei
F J
FJ
D001794:Blood Pressure / Q000502:physiology; D020680:Bronchoscopes; D001999:Bronchoscopy / Q000379:methods*; D002196:Capillaries; D002245:Carbon Dioxide / Q000097:blood; D004562:Electrocardiography; D005336:Fiber Optic Technology / Q000295:instrumentation; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D000860:Hypoxia / Q000145:classification / Q000209:etiology; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008397:Masks; D010092:Oximetry; D010100:Oxygen / Q000097:blood; D010102:Oxygen Inhalation Therapy / Q000295:instrumentation; D011175:Positive-Pressure Respiration / Q000295:instrumentation; D015742:Propofol / Q000008:administration & dosage; D012307:Risk Factors; D013997:Time Factors
D006993:Hypnotics and Sedatives; D002245:Carbon Dioxide; D010100:Oxygen; D015742:Propofol