Clinical observations of high-flow nasal cannula oxygenation in endobronchial ultrasound-guided transbronchial needle aspiration: a randomized controlled study.

Purpose: The purpose of this study was to compare the clinical effects of high-flow nasal cannula oxygenation and nasopharyngeal tube oxygenation in endobronchial ultrasound-guided transbronchial needle aspiration. Patients and methods: A total of 81 patients were enrolled in this study. The patients were randomly divided into two groups: the high-flow nasal cannula oxygenation group (HFNC group, n = 41) and the nasopharyngeal tube oxygenation group (NPT group, n = 40). The HFNC group was given high flow oxygen (oxygen flow rate 45 L/min). In the NPT group, the 6.0 mm ID nasopharyngeal tube was placed and connected to the anesthesia machine's oxygen port for oxygen inhalation, and an oxygen flow rate of 6 L/min was used. The primary outcome was the incidence of hypoxia. The secondary outcomes measured included the treatment measures used for hypoxia (such as jaw lifting or mask-assisted ventilation). The hemodynamic changes at various time points, along with PaO2 and PaCO2 values from arterial blood gas analysis, were documented for this and the occurrence of adverse events were recorded. Results: The incidence of hypoxia in the HFNC group was significantly lower than that in the NPT group (4.9% vs. 25.0%) (P = 0.011). The incidence of jaw lifting and mask-assisted ventilation intervention for hypoxia in the HFNC group was significantly lower than that in the NPT group (P < 0.05). At T3, the PaO2 of the HFNC group was significantly higher than that of the NPT group (P < 0.001); PaCO2 of the HFNC group was significantly lower than of the NPT group (P = 0.015). At T5, the PaO2 of the HFNC group was significantly higher than that of the NPT group (P < 0.001). There was no significant difference in HR, MAP, SpO2, or Ai between the two groups at different time points (P > 0.05). There was also no significant difference in the incidence of adverse events between the two groups (P > 0.05). Conclusion: Compared with nasopharyngeal tube oxygenation, the use of high-flow nasal cannula oxygenation in endobronchial ultrasound-guided transbronchial needle aspiration can significantly reduce the incidence of hypoxia and reduce CO2 storage, which is worthy of clinical promotion. Clinical trial registration: https://www.chictr.org.cn, identifier ChiCTR2400085320.