Tuberculosis and Respiratory Diseases

  • 제82권1호
  • /
  • Pages.81-85
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  • 2019
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  • 1738-3536(pISSN)
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  • 2005-6184(eISSN)
대한결핵및호흡기학회 (The Korean Academy of Tuberculosis and Respiratory Diseases)
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Clinical Effectiveness of High-Flow Nasal Cannula in Hypoxaemic Patients during Bronchoscopic Procedures

  • Chung, Sang Mi (Division of Respiratory and Critical Care Medicine, Korea University Guro Hospital) ;
  • Choi, Ju Whan (Division of Respiratory and Critical Care Medicine, Korea University Guro Hospital) ;
  • Lee, Young Seok (Division of Respiratory and Critical Care Medicine, Korea University Guro Hospital) ;
  • Choi, Jong Hyun (Division of Respiratory and Critical Care Medicine, Korea University Guro Hospital) ;
  • Oh, Jee Youn (Division of Respiratory and Critical Care Medicine, Korea University Guro Hospital) ;
  • Min, Kyung Hoon (Division of Respiratory and Critical Care Medicine, Korea University Guro Hospital) ;
  • Hur, Gyu Young (Division of Respiratory and Critical Care Medicine, Korea University Guro Hospital) ;
  • Lee, Sung Yong (Division of Respiratory and Critical Care Medicine, Korea University Guro Hospital) ;
  • Shim, Jae Jeong (Division of Respiratory and Critical Care Medicine, Korea University Guro Hospital) ;
  • Kang, Kyung Ho (Division of Respiratory and Critical Care Medicine, Korea University Guro Hospital)
  • 투고 : 2017.09.11
  • 심사 : 2018.03.05
  • 발행 : 2019.01.31
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초록

Background: Bronchoscopy is a useful diagnostic and therapeutic tool. However, the clinical use of high-flow nasal cannula (HFNC) in adults with acute respiratory failure for diagnostic and invasive procedures has not been well evaluated. We present our experiences of well-tolerated diagnostic bronchoscopy as well as cases of improved saturation in hypoxaemic patients after a therapeutic bronchoscopic procedure. Methods: We retrospectively reviewed data of hypoxaemic patients who had undergone bronchoscopy for diagnostic or therapeutic purposes from October 2015 to February 2017. Results: Ten patients (44-75 years of age) were enrolled. The clinical purposes of bronchoscopy were for diagnosis in seven patients and for intervention in three patients. For the diagnoses, we performed bronchoalveolar lavage in six patients. One patient underwent endobronchial ultrasonography with transbronchial needle aspiration of a lymph node to investigate tumour involvement. Patients who underwent bronchoscopy for therapeutic interventions had endobronchial mass or blood clot removal with cryotherapy for bleeding control. The mean saturation ($SpO_2$) of pre-bronchoscopy in room air was 84.1%. The lowest and highest mean saturation with HFNC during the procedure was 95% and 99.4, respectively. The mean saturation in room air post-bronchoscopy was 87.4%, which was 3.3% higher than the mean room air $SpO_2$ pre-bronchoscopy. Seven patients with diagnostic bronchoscopy had no hypoxic event. Three patients with interventional bronchoscopy showed improvement in saturation after the procedure. Bronchoscopy was well tolerated in all 10 cases. Conclusion: This study suggests that the use of HFNC in hypoxaemic patients during diagnostic and therapeutic bronchoscopy procedures has clinical effectiveness.

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참고문헌

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  2. High-Flow Nasal Cannula Oxygen Therapy Can Be Effective for Patients in Acute Hypoxemic Respiratory Failure with Hypercapnia: a Retrospective, Propensity Score-Matched Cohort Study vol.35, pp.10, 2019, https://doi.org/10.3346/jkms.2020.35.e67
  3. Lung Ultrasound as a Monitoring Tool vol.83, pp.suppl1, 2020, https://doi.org/10.4046/trd.2020.0149
  4. High-flow nasal cannula for oxygenation during emergency tracheal stenting under flexible bronchoscopy guidance vol.38, pp.3, 2019, https://doi.org/10.4103/lungindia.lungindia_395_20
  5. High flow nasal cannula versus standard low flow nasal oxygen during flexible bronchoscopy in children: A randomized controlled trial vol.56, pp.12, 2019, https://doi.org/10.1002/ppul.25655
  6. High frequency jet ventilation through mask contributes to oxygen therapy among patients undergoing bronchoscopic intervention under deep sedation vol.21, pp.1, 2019, https://doi.org/10.1186/s12871-021-01284-y
  7. Oxygenation strategies during flexible bronchoscopy: a review of the literature vol.22, pp.1, 2019, https://doi.org/10.1186/s12931-021-01846-1
  8. High-flow nasal cannula for reducing hypoxemic events in patients undergoing bronchoscopy: A systematic review and meta-analysis of randomized trials vol.16, pp.12, 2019, https://doi.org/10.1371/journal.pone.0260716
  9. High-flow nasal cannula oxygen therapy for outpatients undergoing flexible bronchoscopy: a randomised controlled trial vol.77, pp.1, 2019, https://doi.org/10.1136/thoraxjnl-2021-217116