High-flow nasal cannula oxygenation in comparison with apnoeic oxygenation during foreign body removal by rigid bronchoscopy: A randomised controlled trial

BACKGROUND AND AIMS: This trial aimed to assess the safety and efficacy of oxygenation using a high-flow nasal cannula (HFNC) compared with the standard apnoeic oxygenation technique during foreign body (FB) removal by a rigid bronchoscope. METHODS: A prospective, blinded, randomised, controlled trial was conducted on subjects planned for FB removal by a rigid bronchoscope. Inclusion criteria were male and female patients aged between 10 and 40 years. The primary outcome was the lowest oxygen saturation level monitored by pulse oximeter during the procedure, and the secondary outcome was the incidence of postoperative atelectasis. RESULTS: Nearly 64 patients were randomised into either HFNC oxygenation (N = 32) or apnoeic oxygenation (N = 32) group. There were no significant differences between the studied groups regarding age, gender, weight, or cardiovascular variables. Intraoperative oxygen saturation was 4% higher in the HFNC group at different times. The end-tidal carbon dioxide measured on induction and after termination by 15 min showed no significant differences between the two groups; however, it was significantly higher in the apnoeic oxygenation group immediately after the procedure, after 5 min, and after 10 min of termination. No adverse effects from the increased end-tidal carbon dioxide were reported. CONCLUSION: HFNC was superior to apnoeic oxygenation technique in maintaining oxygenation status in patients undergoing rigid bronchoscopy for FB removal.