Modified HFNC Therapy for ARF Patients Undergoing Flexible Bronchoscopy

Overview

Acute respiratory failure (AFR) is a serious condition that requires prompt and appropriate intervention to prevent further deterioration and improve outcomes. Bronchoscopy is a commonly used diagnostic and therapeutic procedure in patients with respiratory failure. However, traditional low-flow oxygen supplementation during bronchoscopy may not provide adequate oxygenation and ventilation, leading to complications and worsening of the patient's condition.

High-flow nasal cannula therapy has improved oxygenation and ventilation in critically ill patients, making it a promising alternative to traditional oxygen supplementation during bronchoscopy. The bronchoscope is passed through the nose during all procedures in our center. HFNC oxygen therapy is applied to both nostrils. The bronchoscope occupies one of the nares receiving oxygen therapy during bronchoscopy. As a result, the application of HFNC needs to be optimized. Therefore, the investigators designed a modified HFNC with a single cannula. However, limited data exist on the safety and efficacy of modified HFNC therapy in patients with respiratory failure undergoing bronchoscopy.

Therefore, the aim of this study is to evaluate the impact of modified HFNC therapy on the outcomes of undergoing bronchoscopy in patients with ARF. The findings of this study will contribute to understanding the role of modified HFNC therapy in managing ARF and inform clinical practice.

Eligibility

Inclusion Criteria:

1. Age ≥18 years;
2. Respiratory failure defined as a ratio of the partial pressure of arterial oxygen to the fraction of inspired oxygen (PaO2/FiO2) <300 mm Hg;
3. Clinical indication for FB to diagnose or treat pulmonary disease.

Exclusion Criteria:

1. Pre-existing endotracheal intubation or tracheostomy;
2. Required immediate endotracheal intubation;
3. PaO2/FiO2 <150 mm Hg;
4. Platelet count <60 × 109/L;
5. History of myocardial infarction within the past 6 weeks;
6. Nasopharyngeal obstruction or blockage;
7. Presence of chest skin lesions contraindicating the application of electrical impedance tomography (EIT);
8. Intolerance to HFNC oxygen therapy.