Oxygen Supplementation Is Required in Healthy Volunteers During Bronchoscopy With Lavage

Hypoxemia can complicate bronchoscopy. Common causes of hypoxemia during bronchoscopy include preexisting lung disease, upper airway obstruction, pneumothorax and bleeding secondary to either transbronchial lung biopsy or another interventional bronchoscopic procedure, hypoventilation, oversedation, and laryngospasm. We tested the postulate that bronchoscopy with lavage requires oxygen supplementation in a group of healthy volunteers. The subjects demonstrated no symptoms and the physical examination and the lung function were both normal. The procedure required no sedation or bronchial biopsy. Before the bronchoscopy, a cannula was placed in that naris in which the instrument was not inserted. Volunteers were randomly assigned to receive either oxygen at 2 L/min (n=6) or no oxygen supplementation (n=6). The bronchoscopist was blinded to the provision of oxygen. Saturation values of less than 90% prompted an increase in the oxygen supplementation provided to the subject. All 6 individuals not provided oxygen supplementation at the start of the procedure required O₂ provision at some point of the procedure. This is in contrast to the 6 subjects who were placed on oxygen at the start of the procedure who showed no hypoxemia. In those subjects not receiving O₂ supplementation, desaturation corresponded temporally with the initiation of bronchoalveolar lavage. It is concluded that oxygen supplementation should be provided to all individuals undergoing bronchoscopy with lavage whether these are patients or healthy volunteers.