Uso de la cánula nasal de alto flujo durante la broncoscopía flexible en una unidad de tratamiento intermedio

Abstract

Introduction: Flexible bronchoscopy in an intermediate treatment unit (ITU) has diagnostic and therapeutic indications. Its usefulness focuses on the microbiological diagnosis of pneumonia, the diagnosis of hemoptysis and the study of atelectasis associated with hypoxemia, among others. Howe- ver, it is not free of complications, including desaturation (Sat% < 90%). The use of High Flow Nasal Cannula (HFNC) in ITUpatients could reduce respiratory complications. Patients and Method: A retrospective observational cohort study was carried out that included patients admitted to ITU who underwent flexible bronchoscopy and who used HFNC for the procedure between January 2023 and May 2024 at the Barros Luco-Trudeau Hospital in Santiago, Chile. Clinical records, general laboratory, microbiological and imaging records were reviewed. Indication, intention, oxygen therapy, device used and complications of the procedure were reviewed. The risk factors that predisposed to desaturation during bronchoscopy using HFNC were analyzed. In addition, the predictive value of PaO2/FIO2 and the doses of sedatives to desaturate were analyzed. Results: Of the patients who used HFNC, 23.4% had desaturation (SpO2 < 90%) and presented an average minimum saturation of 93.3%. Risk factors that predisposed to desaturation despite using HFNC were analyzed. These were: smoking, diffuse in- terstitial lung disease and SaO2/FiO2 < 250. Conclusions: The use of HFNC in bronchoscopy allows a good oxygenation profile and a little less than a quarter of patients who used HFNC desaturated. Smoking, diffuseiInterstitial lung disease, and SaO2/FiO2 < 250 were risk factors for desaturation.