We examined the effects of oxygen delivery on the oxygenation status of 21 patients undergoing fiberoptic bronchoscopy. The best FIO2 was achieved by delivering oxygen via a combination of nasal prongs and an endotracheal tube swivel adapter and reservoir, both the prongs and endotracheal tube connected to separate oxygen sources set at 10 L/min. Arterial blood gas and pH values were determined both on room air and on oxygen prior to bronchoscopy, and on oxygen near the end of the procedure. The mean FIO2 at the carina was 0.76 ± 0.15 (range, 0.44-0.90). None of the 21 patients developed hypoxemia during the procedure; however, the mean Pao2 dropped 44 mm Hg during bronchoscopy. The mean Pao2 on oxygen near the end of the procedure was 237 ± 80 mm Hg, with a range of 81-377 mm Hg. No complications occurred as a result of the oxygen delivery system. We conclude that the oxygen delivery method described produces high FIO2 levels and is safe to use in ill patients undergoing fiberoptic bronchoscopy, and that supplemental oxygen administered by this method during oral bronchoscopy is effective in preventing large drops in Pao2.
