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Risk Factors for Predicting Hypoxia in Adult Patients Undergoing Bronchoscopy under Sedation

Tuberculosis and Respiratory Diseases 2020년 83권 4호 p.276 ~ 282
최지수, 이은혜, 이상훈, 임아영, 정경수, 김송이, 정지예, 강영애, 박무석, 장준, 김영삼,
소속 상세정보
최지수 ( Choi Ji-Soo ) - Yonsei University College of Medicine Yongin Severance Hospital Department of Internal Medicine
이은혜 ( Lee Eun-Hye ) - Yonsei University College of Medicine Yongin Severance Hospital Department of Internal Medicine
이상훈 ( Lee Sang-Hoon ) - Yonsei University College of Medicine Severance Hospital Department of Internal Medicine
임아영 ( Leem Ah-Young ) - Yonsei University College of Medicine Severance Hospital Department of Internal Medicine
정경수 ( Chung Kyung-Soo ) - Yonsei University College of Medicine Severance Hospital Department of Internal Medicine
김송이 ( Kim Song-Yee ) - Yonsei University College of Medicine Severance Hospital Department of Internal Medicine
정지예 ( Jung Ji-Ye ) - Yonsei University College of Medicine Severance Hospital Department of Internal Medicine
강영애 ( Kang Young-Ae ) - Yonsei University College of Medicine Severance Hospital Department of Internal Medicine
박무석 ( Park Moo-Suk ) - Yonsei University College of Medicine Severance Hospital Department of Internal Medicine
장준 ( Chang Joon ) - Yonsei University College of Medicine Severance Hospital Department of Internal Medicine
김영삼 ( Kim Young-Sam ) - Yonsei University College of Medicine Severance Hospital Department of Internal Medicine

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.

키워드

Bronchoscopy; Hypoxia; Risk Factors

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