ArticleFrontiers in medicine2025
High-flow nasal cannula oxygenation reduces desaturation risk during diagnostic flexible bronchoscopy under deep sedation: a randomized controlled trial.
Article in Frontiers in medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Deep sedation for flexible bronchoscopy (FB) improves procedural conditions but exacerbates desaturation risks. High-flow nasal cannula (HFNC) may mitigate this situation, yet efficacy under deep sedation remains unproven. Methods: In this randomized trial (ChiCTR2400083597), 340 ASA I-II patients undergoing FB under deep sedation (MOAA/S ≤ 1) received conventional nasal cannula (5 L/min; NC) or HFNC (25/45/65 L/min). The primary outcomes were the incidence of intraoperative desaturation (SpO₂ < 90% > 10s) and intraoperative nadir SpO₂ value. The intraoperative VAS scores for cough that reflect the stimulation inhibition as a result of deep sedation were used as secondary outcome. Other evaluated outcomes included the EtCO₂ values before induction and after awakening, incidence of intraoperative hypertension/hypotension, postoperative adverse events, as well as the willingness to undergo re-examination. Results: All procedures were completed in approximately 5 min, without requiring the application of laryngeal mask airway or endotracheal intubation. HFNC groups showed significantly lower desaturation incidence (HF25:16.87%, HF45:12.05%, HF65:5.00%) versus NC (57.14%, Conclusion: The application of HFNC can markedly lower the risks of desaturation during FB under deep sedation in a weak flow-dependent manner, while partially mitigating carbon dioxide accumulation, enabling safer deep sedation without intubation.
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