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Use of high-flow nasal cannula and intravenous propofol sedation while performing flexible video bronchoscopy in the intensive care unit: Case reports.

Killen Harold Briones ClaudettMónica H Briones-ClaudettBertha López BrionesKillen H Briones ZamoraDiana C Briones MarquezLourdes A Orozco HolguinMaria Fernanda VillavicencioMichelle Grunauer Andrade
Published in: SAGE open medical case reports (2021)
Flexible video bronchoscopy is a procedure that plays an important role in diagnosing various types of pulmonary lesions and abnormalities. Case 1 is a 68-year-old male patient with a lesion in the right lung apex of approximately 4 mm × 28 mm with atelectasis bands due to a crash injury. High-flow system with 35 L/min and fraction of inspired oxygen (FiO 2 ) 0.45 and temperature of 34 °C was installed prior to the video bronchoscopy. SpO 2 was maintained at 98%-100%. The total dose of sedative was 50 mg of propofol. In Case 2, a 64-year-old male patient with bronchiectasis, cystic lesions and pulmonary fibrosis of the left lung field was placed on a high-flow system with 45 L/min and 0.35 FiO 2 at a temperature of 34 °C. SpO 2 was maintained at 100%. The total duration of the procedure was 25 min; SpO 2 of 100% was sustained with oxygenation during maintenance time with the flexible bronchoscope within the airway. The total dose of propofol to reach the degree of desired sedation was 0.5-1 mg/kg. Both patients presented hypotension. For the patient of case 1, a vasopressor (norepinephrine at doses of 0.04 µg/kg/min) was given, and for the patient of case 2, only saline volume expansion was used. The video bronchoscopy with propofol sedation and high-flow nasal cannula allows adequate oxygenation during procedure in the intensive care unit.
Keyphrases
  • case report
  • minimally invasive
  • pulmonary fibrosis
  • ejection fraction
  • extracorporeal membrane oxygenation
  • patient reported