Clinical observations of high-flow nasal cannula oxygenation in endobronchial ultrasound-guided transbronchial needle aspiration: a randomized controlled study

Fangli Yue¹Xinyuan Shi²Huan Zhang¹Shiyu Yu²Min Fu¹Yaxin Wei²Hongyi Xiao¹Yuqi Zhong¹Fanceng Ji¹Peihe Nie^1*

• ¹Weifang People 's Hospital, Weifang, China
• ²Shandong Second Medical University, Weifang, China

Purpose: The purpose of this study was to compare the clinical effects of high-flow nasal cannula oxygenation and nasopharyngeal tube oxygenation in endobronchial ultrasound-guided transbronchial needle . aspiration. Patients and methods: A total of 81 patients were enrolled in this study. The patients were randomly divided into two groups : high-flow nasal cannula oxygenation group (HFNC group, n=41) and nasopharyngeal tube oxygenation group (NPT group, n=40). HFNC group was given high flow oxygen, oxygen flow rate (45 L/min). In the NPT group, the ID 6.0 mm nasopharyngeal tube was placed and connected to the anesthesia machine threaded tube for oxygen inhalation, and the oxygen flow rate (6 L/min) was used. The primary outcome was the incidence of hypoxia. Secondary outcome : treatment measures specifically for hypoxia (jaw lifting, mask assisted ventilation) ;Document the hemodynamic changes at various time points, along with PaO2 and PaCO2 values from arterial blood gas analysis, and record the occurrence of adverse events. Results: The incidence of hypoxia in the Group HFNC was significantly lower than that in the Group NPT (4.9% vs 25.0%) (P = 0.011) . The incidence of jaw lifting and mask-assisted ventilation intervention for hypoxia in the HFNC group was significantly lower than that in the NPT group (P < 0.05). At T3, the PaO2 of the Group HFNC was significantly higher than that of the Group NPT (P < 0.001);PaCO2 of the Group HFNC were significantly lower than of the Group NPT (P=0.015) . At T5, the PaO2 of the Group HFNC was significantly higher than that of the Group NPT (P < 0.001) . There was no significant difference in HR, MAP, SpO2 and Ai between the two groups at different time points (P > 0.05). There was no significant difference in the incidence of adverse events between the two groups (P > 0.05). Conclusion: Compared with nasopharyngeal tube oxygenation, the use of high-flow nasal cannula oxygenation in endobronchial ultrasound-guided transbronchial needle can significantly reduce the incidence of hypoxia, reduce CO2 storage, which is worthy of clinical promotion. Trial registration:Registered with the China Clinical Trial Registry on June 5, 2024:ChiCTR2400085320(https://www.chictr.org.cn).