title: The Feasibility of Tracheal Oxygen Supplementation during Flexible Bronchoscopy.
abstract: BACKGROUND
  Hypoxemia is a frequent adverse event occurring during flexible bronchoscopy and is usually prevented by close monitoring and, if needed, oxygen supplementation by nasal cannula.
  
  
  OBJECTIVE
  We aim to demonstrate that tracheal oxygen supplementation during flexible bronchoscopy is a feasible, safe and effective method to restore oxygen saturation levels after oxygen desaturation.
  
  
  METHODS
  In a first phase, we compare oxygen supplementation by the tracheal or nasal route in a single blinded cross-over design in healthy volunteers. In a second phase, we study patients referred for diagnostic flexible bronchoscopy, who desaturate despite oxygen supplementation by nasal cannula, in order to assess the ability to correct hypoxemia through tracheal oxygen supplementation.
  
  
  RESULTS
  In the first phase, the mean capillary partial pressure of oxygen was 181 mm Hg when oxygen at a flow rate of 4 liters/min was administered by the tracheal route, compared to 125 mm Hg by the nasal route (p < 0.001). The capillary partial pressure of carbon dioxide was not significantly different. During 950 bronchoscopic procedures in the second phase of the trial, 30 patients desaturated below 90% despite oxygen supplementation by nasal cannula. In 22 out of these 30 patients, switching to the tracheal route resulted in a correction of the saturation within 120 s. In the remaining 8 patients, saturation levels were corrected after increasing the oxygen flow rate to 4 liters/min. After restoring saturation levels, the bronchoscopy could be completed in 25 of 30 patients.
  
  
  CONCLUSIONS
  Tracheal oxygen supplementation is safe, feasible and an effective way to restore oxygen saturation levels during flexible bronchoscopy.
authors.affiliation: Department of Respiratory Diseases, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Jonas
authors.initials: J
authors.lastname: Yserbyt
authors.forename: Nikolaas
authors.initials: N
authors.lastname: De Maeyer
authors.forename: Christophe
authors.initials: C
authors.lastname: Dooms
authors.forename: Dries
authors.initials: D
authors.lastname: Testelmans
authors.forename: Inge
authors.initials: I
authors.lastname: Muylle
authors.forename: Marie
authors.initials: M
authors.lastname: Bruyneel
authors.forename: Vincent
authors.initials: V
authors.lastname: Ninane
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001999:Bronchoscopy / Q000009:adverse effects / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D000860:Hypoxia / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000008:administration & dosage*
chemical_list: D010100:Oxygen