Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Risk Factors for Predicting Hypoxia in Adult Patients Undergoing Bronchoscopy under Sedation

  • Choi, Ji Soo (Division of Pulmonology, Allergy and Critical Care Medicine, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine) ;
  • Lee, Eun Hye (Division of Pulmonology, Allergy and Critical Care Medicine, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine) ;
  • Lee, Sang Hoon (Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine) ;
  • Leem, Ah Young (Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine) ;
  • Chung, Kyung Soo (Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine) ;
  • Kim, Song Yee (Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine) ;
  • Jung, Ji Ye (Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine) ;
  • Kang, Young Ae (Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine) ;
  • Park, Moo Suk (Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine) ;
  • Chang, Joon (Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine) ;
  • Kim, Young Sam (Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine)
  • Received : 2020.01.17
  • Accepted : 2020.07.09
  • Published : 2020.10.31
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Abstract

Background: Flexible bronchoscopy is one of the essential procedures for the diagnosis and treatment of pulmonary diseases. The purpose of this study was to identify the risk factors associated with the occurrence of hypoxia in adults undergoing flexible bronchoscopy under sedation. Methods: We retrospectively analyzed 2,520 patients who underwent flexible bronchoscopy under sedation at our tertiary care university hospital in South Korea January 1, 2013-December 31, 2014. Hypoxia was defined as more than 5%-point reduction in the baseline percutaneous oxygen saturation (SpO2) or SpO2 <90% for >1 minute during the procedure. Results: The mean age was 64.7±13.5, and 565 patients developed hypoxia during the procedure. The mean sedation duration and midazolam dose for sedation were 31.1 minutes and 3.9 mg, respectively. The bivariate analysis showed that older age, a low forced expiratory volume in one second (FEV1), use of endobronchial ultrasound, the duration of sedation, and the midazolam dose were associated with the occurrence of hypoxia during the procedure, while the multivariate analysis found that age >60 (odds ratio [OR], 1.32), a low FEV1 (OR, 0.99), and a longer duration of sedation (>40 minutes; OR, 1.33) were significant risk factors. Conclusion: The findings suggest that patients older than age 60 and those with a low FEV1 tend to develop hypoxia during the bronchoscopy under sedation. Also, longer duration of sedation (>40 minutes) was a significant risk factor for hypoxia.

Keywords

References

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