Study on the prevention of hypoxemia during painless bronchoscopy in patients with bronchial tuberculosis by modified chest compression

doi:10.19871/j.cnki.xfcrbzz.2023.04.009

Abstract

Abstract: Objective To observe the clinical effect of modified chest compression in preventing hypoxemia in patients with bronchial tuberculosis during painless bronchoscopy. Method Select 200 patients with bronchial tuberculosis (EBTB) who underwent bronchoscopy diagnosis and treatment at Shenzhen Third People's Hospital from May to October 2022, patients were randomly assigned into two groups: control group (group C) and test group (group T), 100 cases per group. The anesthesia method is intravenous injection with midazolam and remifentanil, inserting bronchoscopy after patient's consciousness disappears. During the surgery, jaw thrust (in group C) or chest compressions (in group T) was performed if apnea occurred over 10 seconds. If the state continues to deteriorate and plus oxygen saturation (SpO₂) runs to be lower than 90% for more than 60 seconds, the staff will suspend operation and perform mask ventilation. The heart rate (HR), mean arterial pressure (MAP), SpO₂, anesthetic dosage, recovery time, hypoxemia and times of interruption were recorded at the following time points: before anesthesia (T0), bronchoscope going through glottis (T1), end of operation (T2), leaving room (T3). Result Compared with T0, both groups had an increase in MAP, a faster increase in HR, and a decrease in SpO₂ during surgery. After surgery, they gradually recovered to the basic level, but there was no statistically significant difference in MAP and HR between the two groups at different time points (P>0.05). Compared with group C, SpO₂ in group T was maintained at a high level at T1 and T2 (P<0.05), and the incidence of hypoxemia and interruption in group T was significantly decreased (P<0.05). There was no significant difference in the incidence of apnea, lowest value of SpO₂, and other adverse reactions between the two groups (P>0.05). There were no chest pain, rib fracture, pneumothorax and other adverse reactions related with chest compression in group T. Conclusion Modified chest compression is a safe and feasible technique during painless bronchoscopy in patients with bronchial tuberculosis, which can effectively prevent hypoxemia and reduce the interruptions of operation.

Key words: Chest compressions, Endobronchial tuberculosis, Bronchoscopy, Hypoxemia

CLC Number:

R52
R459.9

Yang Xiaorui, Xuan Peng, Li Jinpei, Zhang Liang, Liu Yong, Liu Minqiang, He Renliang. Study on the prevention of hypoxemia during painless bronchoscopy in patients with bronchial tuberculosis by modified chest compression[J]. Electronic Journal of Emerging Infectious Diseases, 2023, 8(4): 41-44.

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