Introduction

Medical thoracoscopy is a complementary diagnostic and therapeutic procedure of pleural disease using similar sedation protocols as bronchoscopy. Correspondingly, thoracoscopy performed under sedation is associated with significant hypoventilation. High flow nasal oxygen (HFNO) has been shown to have positive effects for patients after extubation following surgical thoracoscopy.

Aim

This study investigates whether HFNO improved oxygenation in patients undergoing medical thoracoscopy.

Methods

In this investigator initiated, prospective, randomised controlled trial consecutive patients undergoing medical thoracoscopy were randomised to either 4 l/min conventional supplemental oxygen by nasal cannula or oxygen supplied using LM Flow 100 (Löwenstein Medical GmbH, Bad Ems, Germany) starting at a rate of 60 l/min and fraction of oxygen of 0.6. The primary endpoint is the mean lowest oxygen saturation during medical thoracoscopy.

Results

The majority of the 27 randomised patients (14:13) included in the interim analysis were male (63%) and had a mean age of 73 ± 12 years. We observed that the lowest oxygen saturation was similar between groups (86% vs 85%, p=0.8). Moreover, there was no difference in the mean oxygen saturation during the procedure between groups (96% vs 96%, p=0.6). Additionally, the transcutaneous measured carbon dioxide levels did not differ between groups (42 vs 46 mmHg, p=0.2).

Conclusion

Oxygen supplementation using HFNO during medical thoracoscopy does not improve oxygen saturation compared to conventional supplemental oxygen by nasal cannula.