The effect of Oxygen application with nCPAP for the prevention of
desaturation during EBUS-TBNA
Abstract
Background: EBUS-TBNA is a frequently used diagnostic method for
mediastinal/hilar lymphadenopathies and masses. This procedure is
performed with intravenous sedation (IVS). During IVS, patients often
develop hypoxemia and nasal oxygen delivery is insufficient in some
patients. The aim of this study was to investigate the effect of oxygen
application with nCPAP on hypoxemia during EBUS-TBNA. Methods: Patients
with EBUS-TBNA indication who did not have any serious heart-lung
disease were randomly divided into two groups. One group received only
oxygen and the other group received nCPAP+oxygen. Patient
characteristics, arterial oxygen saturations, anesthetic agents, CPAP
pressures, oxygen concentrations and processing times were recorded
during the procedure. Practitioner satisfaction was evaluated at the
end. Results: 29 nCPAP+oxygen, 31 oxygen patients were included in the
study. There were no significant differences in terms of age, sex,
smoking history and presence of additional diseases in two groups. Neck
circumference, BMI and STOP BANG questionnaire values were similar.
Desaturation time was significantly longer in oxygen group than
nCPAP+oxygen group (316±390 sec, 12±118 sec, respectively, p=0,019).
Snoring was detected during the procedure in 22 patients in the oxygen
group and in 11 patients in the nCPAP group (p=0,01). There were no
serious complications in both groups. Practitioner satisfaction was
higher in the nCPAP group but this was not statistically significant
(p=0,052). Conclusions: Oxygen application by nCPAP during EBUS-TBNA
under IVS, significantly reduces desaturation time. Oxygen delivery with
nCPAP seems to be a better choice especially for the patients with high
Mallampati index.