Assessment of High Flow Nasal Cannula Oxygenation in EBUS Bronchoscopy

University College Hospital Galway40 enrolled

Overview

This study is a prospective randomised trial where a computer will randomly allocate patients to one of two possible methods of delivering oxygen during the procedure of bronchoscopy. This trial compares high flow nasal cannula (HFNC) with nasal prongs in delivering oxygen to patients undergoing endo-bronchial ultrasound guided trans- bronchial nodal aspiration (EBUS-TBNA) a specialised form of bronchoscopy procedure. HFNC uses humidified higher gas flow rates than conventional low flow systems such as nasal prongs which are limited by the respiratory rate and effort.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Lung Cancer Lymphadenopathy

Interventions

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Subjects with a peripheral arterial pulse oximetry ≥ 90% breathing room air * Age ≥ 18 years * Able to breathe spontaneously throughout the procedure Exclusion Criteria: * Respiratory or cardiac failure * Recent myocardial infarction \< 6 weeks ago * On long term oxygen therapy, those with tracheostomy and/ or non-invasive or invasive mechanical ventilation * Nasal and/ or nasopharyngeal disease * Inability to give informed consent * Dementia * Hepatic or end stage renal disease * Pregnancy

Outcomes

Primary Outcomes

drop in oxygen saturation during procedure

the difference in oxygen saturation levels between pre-treatment assessments and the lowest saturation level achieved during treatment

Time frame: through procedure completion defined as withdrawing scope from patient's mouth, an average of 30 minutes

Secondary Outcomes

change in venous CO2

Change in venous CO2 1 hour after procedure compared to pre-procedure level

Time frame: 1 hour after procedure

end tidal CO2 during procedure

Measured with tip of scope at lower trachea

Time frame: through procedure completion defined as withdrawing scope from patient's mouth an average of 30 minutes

Patient experience measure on a visual analogue scale

Time frame: up to 3 hours after procedure

endotracheal intubation during or post procedure

Time frame: 24 hours