de Jaureguizar Tesas Maria Rosa, Matson Hannah, Tappin Simon, Thomas Emily
Department of Emergency and Critical Care, Veterinary Teaching Hospital, Georgia University (UGA), Athens, GA, United States.
Department of Emergency and Critical Care, Royal Veterinary College, London, United Kingdom.
Front Vet Sci. 2023 Mar 30;10:1088103. doi: 10.3389/fvets.2023.1088103. eCollection 2023.
High-Flow Nasal Oxygen Therapy is a method to deliver warmed, humidified air-oxygen blended at high flow rates to patients through a nasal cannula using a specialized, commercially available machine. This is a well-tolerated, safe and effective method for oxygen delivery to healthy and hypoxemic dogs. Patients undergoing bronchoscopic procedures frequently develop hypoxemia. Human trials have shown a reduction in incidents of hypoxemic events and higher pulse oximeter oxygen saturation during bronchoscopies in patients on High-Flow Nasal Oxygen.
This is a single-centre, prospective case series. All dogs weighing between 5 and 15 kg and undergoing bronchoscopy during the study period (03/07/2022-01/10/2022) were eligible.
Twelve patients were eligible for inclusion of which four were enrolled. No clinically significant complications related to the use of High-Flow Nasal Oxygen Therapy were recorded. Two of the patients were re-intubated post bronchoscopy due to clinician preference for recovery. One of the patients had a self-limiting period of severe hypoxemia with a pulse oximeter oxygen saturation of 84% for < 1 min during bronchoalveolar lavage, and whilst undergoing High-Flow Nasal Oxygen administration. Another patient had a self-limiting episode of mild hypoxemia (SpO of 94% lasting < 1 min) 5 min after completion of bronchoalveolar lavage.
No clinically relevant complications relating to High-Flow Nasal Oxygen Therapy were recorded in this case series, although further studies are required to confirm this conclusion. This initial data suggests that the use of High-Flow Nasal Oxygen therapy during bronchoscopy is feasible and potentially safe, although it may not prevent hypoxemia in these patients. The use of High-Flow Nasal Oxygen Therapy during bronchoscopy in small patients carries multiple potential benefits and further studies to compare its efficacy against other traditional oxygen delivery systems are warranted in this patient population.
高流量鼻导管给氧疗法是一种通过专用的市售设备，以高流速将温热、湿润的空气-氧气混合气体经鼻导管输送给患者的方法。这是一种对健康和低氧血症犬类进行给氧的耐受性良好、安全且有效的方法。接受支气管镜检查的患者经常会出现低氧血症。人体试验表明，高流量鼻导管给氧的患者在支气管镜检查期间，低氧血症事件的发生率降低，脉搏血氧饱和度更高。
这是一个单中心前瞻性病例系列研究。所有体重在5至15千克之间且在研究期间（2022年7月3日至2022年10月1日）接受支气管镜检查的犬只均符合条件。
12只犬符合纳入标准，其中4只被纳入研究。未记录到与使用高流量鼻导管给氧疗法相关的具有临床意义的并发症。由于临床医生倾向于让患者恢复，其中2只犬在支气管镜检查后重新插管。其中1只犬在支气管肺泡灌洗期间，在接受高流量鼻导管给氧时出现了持续不到1分钟的严重低氧血症自限期，脉搏血氧饱和度为84%。另1只犬在支气管肺泡灌洗完成后5分钟出现了持续不到1分钟的轻度低氧血症自限性发作（血氧饱和度为94%）。
尽管需要进一步研究来证实这一结论，但该病例系列中未记录到与高流量鼻导管给氧疗法相关的具有临床相关性的并发症。这些初步数据表明，在支气管镜检查期间使用高流量鼻导管给氧疗法是可行的且可能是安全的，尽管它可能无法预防这些患者出现低氧血症。在小体型患者的支气管镜检查中使用高流量鼻导管给氧疗法具有多种潜在益处，因此有必要进一步开展研究，以比较其与其他传统给氧系统的疗效。
