The current practice of oxygenation and/or ventilation supports in patients undergoing Fiberoptic Bronchoscopy is very heterogeneous among studies published in the literature; in addition, clear outcomes advantages of one strategy over another currently lack. The goal of this observational study is to describe the current practice of oxygenation and/or ventilation supports in patients undergoing Fiberoptic Bronchoscopy (FOB), stratified by baseline respiratory condition, co-morbidities, type of procedure and hospital settings. Investigators will enroll all adult patients undergoing any fiberoptic bronchoscopy in any clinical settings (from outpatients to critically ill patients). No specific exclusion criteria are indicated for enrollment in this study. Investigators will record the following data: * Patient's baseline data. * Type of FOB procedure: toilet bronchoscopy (for secretions, blood, mucus plugs removal), broncho-aspirate (BAS), bronchoalveolar lavage (BAL), brushing for cytology, biopsy, endobronchial ultrasound (EBUS). The type and size of bronchoscope (with or without an internal/external camera) and the time of the procedure will be also recorded. * Type of supportive strategy: no support, Standard Oxygen Therapy, High Flow Nasal Cannula, Continuous Positive Airway Pressure and or non invasive ventilation trough mask or helmet, invasive mechanical ventilation. * Sedation * Intra-procedural vital parameters * Occurrence of adverse events: desaturation (i.e. SpO2\< 90% for at least 10 seconds), severe desaturation (i.e. SpO2\< 80%), need for procedure interruption, hypotensive (systolic blood pressure \<90 mmHg) or hypertensive (systolic blood pressure \>140 mmHg) events, new onset of cardiac arrhythmias (specify the rhythm) or myocardial ischemia or electrocardiographic ST-alterations, neurological events (i.e. severe sensorium depression, psychomotor agitation). * Post-procedural vital parameters (15 minutes after the procedure). * Clinical outcomes: need for support escalation, need for admission to ward (for outpatient) or ICU (for outpatients and ward-admitted patient).
Study Type
OBSERVATIONAL
Enrollment
10,000
Patients will undergo to the bronchial endoscopy procedure required for their clinical condition: toilet bronchoscopy (for secretions, blood, mucus plugs removal), broncho-aspirate (BAS), bronchoalveolar lavage (BAL), brushing for cytology, biopsy, endobronchial ultrasound (EBUS).
AOU Mater Domini
Catanzaro, Italy
RECRUITINGType of oxygenation strategy adopted
The type of oxygenation strategy (standard oxygen therapy, high flow nasal cannula, continuous positive airway pressure, non invasive ventilation or invasive mechanical ventilation) adopted during the bronchoscopy will be recorded.
Time frame: Through the endoscopy completion, an average of 30 minutes
Type of sedation strategy adopted
The type of sedation strategy (topical anesthesia, midazolam, propofol, remifentanil, fentanyl, dexmedetomidine, neuromuscular blocking agents) adopted during the bronchoscopy will be recorded.
Time frame: Through the endoscopy completion, an average of 30 minutes
Lowest peripheral oxygen saturation
The lowest peripheral oxygen saturation recorded during the procedure
Time frame: Through the endoscopy completion, an average of 30 minutes
Lowest heart rate
The lowest heart rate recorded during the procedure
Time frame: Through the endoscopy completion, an average of 30 minutes
Highest heart rate
The highest heart rate recorded during the procedure
Time frame: Through the endoscopy completion, an average of 30 minutes
Lowest systolic blood pressure
The lowest systolic blood pressure recorded during the procedure
Time frame: Through the endoscopy completion, an average of 30 minutes
Highest systolic blood pressure
The highest systolic blood pressure recorded during the procedure
Time frame: Through the endoscopy completion, an average of 30 minutes
Duration of the procedure
The time duration of the procedure in minutes, from the beginning to the end of the endoscopy procedure
Time frame: From the beginning to the end of the endoscopy procedure
Desaturation events
Occurrence of peripheral oxygen saturation \< 90% for at least 10 seconds
Time frame: Through the endoscopy completion, an average of 30 minutes
Severe desaturation events
Occurrence of peripheral oxygen saturation \< 80%
Time frame: Through the endoscopy completion, an average of 30 minutes
Hypotensive events
Occurrence of systolic blood pressure \<90 mmHg
Time frame: Through the endoscopy completion, an average of 30 minutes
Hypertensive events
Occurrence of systolic blood pressure \>140 mmHg
Time frame: Through the endoscopy completion, an average of 30 minutes
Need for support escalation
Need to escalate the oxygenation/ventilation support from from standard oxygen therapy (lowest support) to High Flow Nasal Cannula, Continuous Positive Airway Pressure, Non Invasive Ventilation or invasive Mechanical Ventilation (highest grade of support)
Time frame: Through the endoscopy completion, an average of 30 minutes
Admission to ward or intensive care unit
Need for admission to ward or intensive care unit after the endoscopy completion
Time frame: At the end of the endoscopy completion, after an average of 30 minutes from study start
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