Incidence and Risk Factors of Hypoxemia During Interventional Rigid Bronchoscopy Under Spontaneous-assisted Ventilation

J Bronchology Interv Pulmonol. 2017 Oct;24(4):268-274. doi: 10.1097/LBR.0000000000000387.

Abstract

Background: Interventional rigid bronchoscopy for tracheobronchial stenosis can be performed under total intravenous anesthesia and spontaneous-assisted ventilation. Intraoperative hypoxemia can occur during this procedure, but the incidence and risk factors have not yet been determined.

Methods: Medical records of patients who underwent rigid bronchoscopy for the treatment of tracheobronchial stenosis under total intravenous anesthesia and spontaneous-assisted ventilation during the study period from January 2011 to December 2012 were retrospectively reviewed.

Results: There were 126 patients who underwent 263 procedures. The 2 main causes of tracheobronchial stenosis were tuberculosis (41.3%) and malignancy (35.7%). The 2 main locations of stenotic area were the trachea (58.6%) and the left main bronchus (46.4%). Tracheobronchial dilatation and stent insertion were performed in 78.7% and 21.3% of patients, respectively. The incidence of intraoperative hypoxemia was 25.5%. Independent risk factors for intraoperative hypoxemia were a degree of tracheal stenosis ≥75% (odds ratio: 2.48; 95% confidence interval, 1.19-5.17) and tumor removal procedure (odds ratio: 2.9; 95% confidence interval, 1.13-7.41).

Conclusions: Incidence of intraoperative hypoxemia during interventional rigid bronchoscopy for tracheobronchial stenosis under spontaneous-assisted ventilation was 25.5%. Risk factors for hypoxemia were a degree of tracheal stenosis ≥75% and tumor removal procedure.

MeSH terms

  • Adult
  • Anesthesia, General / methods
  • Bronchi / diagnostic imaging
  • Bronchi / pathology
  • Bronchial Diseases / etiology
  • Bronchoscopy / adverse effects*
  • Bronchoscopy / instrumentation
  • Bronchoscopy / methods
  • Constriction, Pathologic / etiology
  • Female
  • Humans
  • Hypoxia / epidemiology*
  • Hypoxia / etiology
  • Incidence
  • Intraoperative Complications / epidemiology
  • Male
  • Middle Aged
  • Respiration, Artificial / instrumentation*
  • Retrospective Studies
  • Risk Factors
  • Trachea / diagnostic imaging
  • Trachea / pathology
  • Tracheal Stenosis / etiology