Abdominal Displacement Ventilation: An Effective Intervention for Sedation-Induced Hypoxia

BACKGROUND: Sedation for bronchoscopy at times causes hypoxia. The application of positive pressure ventilation for sedation-induced hypoxia often requires cessation of the bronchoscopy. In contrast, ventilation effected via cyclical abdominal compression, if effective, would allow bronchoscopy to proceed. Initial trials of abdominal displacement ventilation (ADV) proved successful. This report documents extended experience with ADV. OBJECTIVE: To evaluate and report the efficacy and applicability of ADV in the setting of sedation-induced hypoxia for consecutive patients over an extended interval. METHODS: Based upon its initial efficacy, ADV had been incorporated into the standard approach to sedation-induced hypoxia. We retrospectively reviewed all bronchoscopies performed by interventional pulmonary over a 12-month interval. Management and efficacy of every episode of sedation-induced hypoxia were documented. RESULTS: Over the study interval, 893 bronchoscopies had been performed, with sedation-induced hypoxia occurring in 38 (4%). ADV was possible in 37 of the 38 patients. In every case, ADV was effective and allowed completion of the procedure. There were no adverse effects. CONCLUSION: ADV is a simple, effective, noninvasive approach to sedation-induced hypoxia that effects adequate ventilation and allows safe continuance of procedures.