Kim Hye Jin, Lee Chang Young, Lee Kyuho, Kim Namo, Lee Seungyeon, Oh Young Jun
Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea.
Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, Korea.
Korean J Anesthesiol. 2025 Feb;78(1):39-47. doi: 10.4097/kja.24517. Epub 2024 Dec 12.
The efficacy of high-flow nasal oxygenation (HFNO) in improving oxygenation is influenced by several factors, and its effectiveness is not always guaranteed. Therefore, we aimed to compare the effects of HFNO and standard low-flow nasal oxygenation during rigid bronchoscopy in the apneic patients.
All patients were administered general anesthesia with full muscle relaxation and were randomly assigned to receive either HFNO (HFNO group) or standard low-flow oxygenation (Standard group). The study endpoints included the lowest peripheral oxygen saturation (SpO2), hypoxemia-related surgical interruptions (SpO2 ≤ 94%), and changes in arterial oxygen tension (PaO2) and carbon dioxide tension (PaCO2) during the apnea period for rigid bronchoscopy.
A total of 53 patients completed the study. No significant differences were found between the HFNO and the Standard groups in the lowest SpO2 levels (median [Q1, Q3]; 99 [98, 100]% vs. 98 [94, 100]%, P = 0.059) and in the increase rate of PaCO2 (mean ± standard deviation [SD]; 1.6 ± 0.7 mmHg/min vs. 2.0 ± 0.8 mmHg/min, P = 0.064). However, the HFNO group had fewer patients with hypoxemia-related surgical interruptions than the Standard group (1 [3.8%] vs. 8 [29.6%], P = 0.024) and exhibited an attenuated decline rate in PaO2 (median [Q1, Q3]: 4.6 [0.0, 7.9] mmHg/min vs. 10.5 [6.4, 12.9] mmHg/min, P = 0.005).
While HFNO did not enhance the lowest SpO2 levels in comparison with standard low-flow oxygenation, it did reduce hypoxemia-related surgical interruptions with an attenuated decline in PaO2. Therefore, HFNO has considerable clinical efficacy for rigid bronchoscopy.
高流量鼻导管给氧（HFNO）改善氧合的效果受多种因素影响，其有效性并非总能得到保证。因此，我们旨在比较HFNO与标准低流量鼻导管给氧在窒息患者硬质支气管镜检查期间的效果。
所有患者均接受全身麻醉并完全肌肉松弛，随机分为接受HFNO（HFNO组）或标准低流量给氧（标准组）。研究终点包括最低外周血氧饱和度（SpO2）、低氧血症相关的手术中断（SpO2≤94%）以及硬质支气管镜检查窒息期间动脉血氧分压（PaO2）和二氧化碳分压（PaCO2）的变化。
共有53例患者完成研究。HFNO组与标准组在最低SpO2水平（中位数[Q1，Q3]；99[98，100]%对98[94，100]%，P = 0.059）和PaCO2升高率（均值±标准差[SD]；1.6±0.7 mmHg/分钟对2.0±0.8 mmHg/分钟，P = 0.064）方面未发现显著差异。然而，HFNO组低氧血症相关手术中断的患者比标准组少（1例[3.8%]对8例[29.6%]，P = 0.024），并且PaO2下降率减缓（中位数[Q1，Q3]：4.6[0.0，7.9] mmHg/分钟对10.5[6.4，12.9] mmHg/分钟，P = 0.005）。
虽然与标准低流量给氧相比，HFNO并未提高最低SpO2水平，但它确实减少了低氧血症相关的手术中断，且PaO2下降减缓。因此，HFNO对硬质支气管镜检查具有相当大的临床疗效。
