title: Flexible bronchoscopy in supine or sitting position: a randomized prospective analysis of safety and patient comfort.
abstract: BACKGROUND
  Flexible bronchoscopy is performed under many different conditions (sitting/supine position, with or without oxygen prophylaxis) in different hospitals according to local traditions.
  
  
  OBJECTIVE
  The study was to investigate the effect of different patient positions in flexible bronchoscopy on patient comfort and safety.
  
  
  METHODS
  We started a prospective randomized controlled trial to compare bronchoscopy in supine and sitting positions. Consecutive outpatients undergoing regular diagnostic bronchoscopy were included and randomly selected to be in a supine or sitting position. A self-administrated questionnaire was taken from the patients after the bronchoscopy and the answers were evaluated. A total of 107 patients were included; 46 underwent bronchoscopy in the supine position.
  
  
  RESULTS
  Of all patients, 52% showed a decrease in oxygen saturation of more than 4%. The sitting position is a risk factor for oxygen decline, with a relative risk of 2.46.
  
  
  CONCLUSIONS
  We recommend performing the procedure while the patient is in a supine position. We also recommend routine prophylactic low-flow supplemental oxygen in all patients undergoing bronchoscopy.
authors.affiliation: Alysis Heathcare Group, Rijnstate Hospital, Arnhem, The Netherlands.
authors.forename: Janet P
authors.initials: JP
authors.lastname: van Zwam
authors.forename: Erik F G
authors.initials: EF
authors.lastname: Kapteijns
authors.forename: Sylvia
authors.initials: S
authors.lastname: Lahey
authors.forename: Hans J M
authors.initials: HJ
authors.lastname: Smit