Feasibility analysis of flexible bronchoscopy in conjunction with noninvasive ventilation for therapy of hypoxemic patients with Central Airway Obstruction: a retrospective study

Xiaoke Chen; Yiping Zhou; Haiqiong Yu; Yue Peng; Liping Xia; Nian Liu; Hairong Lin

doi:10.7717/peerj.8687

Feasibility analysis of flexible bronchoscopy in conjunction with noninvasive ventilation for therapy of hypoxemic patients with Central Airway Obstruction: a retrospective study

PeerJ. 2020 Apr 8:8:e8687. doi: 10.7717/peerj.8687. eCollection 2020.

Authors

Xiaoke Chen¹, Yiping Zhou¹, Haiqiong Yu¹, Yue Peng², Liping Xia¹, Nian Liu¹, Hairong Lin¹

Affiliations

¹ Department of Respiratory Medicine, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, China.
² Department of Anesthesia, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, China.

Abstract

Background: Interventional bronchoscopy for hypoxemic patients with central airway obstruction (CAO) is typically performed under general anesthesia. This approach poses remarkable challenge for both bronchoscopist and anesthesiologist. Noninvasive ventilation (NIV) during flexible bronchoscopy (FB) has been successfully used in hypoxemic patients, but rarely in the treatment of hypoxemic patients with CAO.

Objective: To evaluate the feasibility of therapeutic FB assisted with NIV for therapy of hypoxemic patients with CAO.

Method: Twenty-nine hypoxemic CAO patients treated with FB from December 2010 to May 2016 in our hospital were retrospectively reviewed, either aided with NIV under sedation (NIV group ) or through artificial airway under general anesthesia (control group). Interventional procedures included balloon dilation, electrocautery and argon plasma coagulation.

Result: Fifteen patients were enrolled in the NIV group and 14 in the control group. The success rate (93.3% VS 92.9%, p = 1.0), procedure time (60.5 ± 4.2 min VS 67.8 ± 5.6 min, p = 0.31) and oxygenation improvement between the two groups have no significant difference. Less reduction of systolic blood pressure and heart rate during procedure was observed in the NIV group. The NIV group showed shorter admission time before procedure than the control group (35.1 ± 4.6 h VS 55.6 ± 5.6 h, p < 0.01). In addition, procedure fee in the NIV group was significantly less than that in the control group (540.7 ± 62.8$ VS975.4 ± 69.5$, p < 0.0001).

Conclusion: FB assisted with NIV is a safe, efficient and economic method for therapy of selected hypoxemic patients with CAO.

Keywords: Bronchoscopy.

Grants and funding

This work was supported by the planned Science and Technology Project of Shenzhen Municipality (No. 20140329165954). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.