Objective To optimize the oxygen therapy regimens for infants with pulmonary diseases during bronchoscopy. Methods A prospective randomized, controlled, and single-center clinical trial was conducted on 42 infants who underwent electronic bronchoscopy from July 2019 to July 2021. These infants were divided into a nasal cannula (NC) group and a modified T-piece resuscitator (TPR) group using a random number table. The lowest intraoperative blood oxygen saturation was recorded as the primary outcome, and intraoperative heart rate and respiratory results were recorded as the secondary outcomes. Results Compared with the NC group, the modified TPR group had a significantly higher level of minimum oxygen saturation during surgery and a significantly lower incidence rate of hypoxemia (P<0.05). In the modified TPR group, there were 6 infants with mild hypoxemia, 2 with moderate hypoxemia, and 1 with severe hypoxemia, while in the NC group, there were 3 infants with mild hypoxemia, 5 with moderate hypoxemia, and 9 with severe hypoxemia (P<0.05). The modified TPR group had a significantly lower incidence rate of intraoperative respiratory rhythm abnormalities than the NC group (P<0.05), but there was no significant difference in the incidence rate of arrhythmias between the two groups (P>0.05). Conclusions Modified TPR can significantly reduce the risk of hypoxemia in infants with pulmonary diseases during electronic bronchoscopy, and TPR significantly decreases the severity of hypoxemia and the incidence of respiratory rhythm abnormalities compared with traditional NC.
Key words
T-piece resuscitator /
Nasal cannula oxygen /
Electronic bronchoscopy /
Clinical efficacy /
Infant
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
References
1 Arwas N, Goldbart A, Aviram M, et al. Flexible bronchoscopy in pediatric patients with Down syndrome: a case-control study of the indications, findings, and complications[J]. Pediatr Pulmonol, 2023, 58(6): 1658-1664. PMID: 36811243. DOI: 10.1002/ppul.26371.
2 Schnapf BM. Oxygen desaturation during fiberoptic bronchoscopy in pediatric patients[J]. Chest, 1991, 99(3): 591-594. PMID: 1995213. DOI: 10.1378/chest.99.3.591.
3 Patolia S, Farhat R, Subramaniyam R. Bronchoscopy in intubated and non-intubated intensive care unit patients with respiratory failure[J]. J Thorac Dis, 2021, 13(8): 5125-5134. PMID: 34527353. PMCID: PMC8411155. DOI: 10.21037/jtd-19-3709.
4 Hinder M, Tracy M. Newborn resuscitation devices: the known unknowns and the unknown unknowns[J]. Semin Fetal Neonatal Med, 2021, 26(2): 101233. PMID: 33773952. DOI: 10.1016/j.siny.2021.101233.
5 Drevhammar T, Falk M, Donaldsson S, et al. Neonatal resuscitation with T-piece systems: risk of inadvertent PEEP related to mechanical properties[J]. Front Pediatr, 2021, 9: 663249. PMID: 34164358. PMCID: PMC8215339. DOI: 10.3389/fped.2021.663249.
6 国家卫生健康委员会人才交流服务中心儿科呼吸内镜诊疗技术专家组, 中国医师协会儿科医师分会内镜专业委员会, 中国医师协会内镜医师分会儿科呼吸内镜专业委员会, 等. 中国儿科可弯曲支气管镜术指南（2018年版）[J]. 中华实用儿科临床杂志, 2018, 33(13): 983-989. DOI: 10.3760/cma.j.issn.2095-428X.2018.13.006.
7 Takzare A, Ariana P, Malekianzadeh B, et al. Comparing topical administration of lidocaine alone and in combination with alfentanil in children undergoing bronchoscopy[J]. J Family Med Prim Care, 2021, 10(3): 1332-1335. PMID: 34041174. PMCID: PMC8140266. DOI:10.4103/jfmpc.jfmpc_1719_20.
8 Sharluyan A, Osona B, Frontera G, et al. High flow nasal cannula versus standard low flow nasal oxygen during flexible bronchoscopy in children: a randomized controlled trial[J]. Pediatr Pulmonol, 2021, 56(12): 4001-4010. PMID: 34506689. DOI: 10.1002/ppul.25655.
9 Carlens J, Fuge J, Price T, et al. Complications and risk factors in pediatric bronchoscopy in a tertiary pediatric respiratory center[J]. Pediatr Pulmonol, 2018, 53(5): 619-627. PMID: 29393584. DOI: 10.1002/ppul.23957.
10 DeBoer EM, Prager JD, Kerby GS, et al. Measuring pediatric bronchoscopy outcomes using an electronic medical record[J]. Ann Am Thorac Soc, 2016, 13(5): 678-683. PMID: 26816220. PMCID: PMC6137899. DOI: 10.1513/AnnalsATS.201509-576OC.
11 Abulebda K, Abu-Sultaneh S, Ahmed SS, et al. Intensivist-based deep sedation using propofol for pediatric outpatient flexible bronchoscopy[J]. World J Crit Care Med, 2017, 6(4): 179-184. PMID: 29152464. PMCID: PMC5680344. DOI: 10.5492/wjccm.v6.i4.179.
12 Li J, Scott JB, Lee JH. Defining the optimal role of high-flow nasal cannula in pediatric procedural sedation[J]. Pediatr Pulmonol, 2020, 55(12): 3225-3227. PMID: 33048458. DOI: 10.1002/ppul.25105.
PDF(638 KB)
