Fibreoptic bronchoscopy in sedated infants facilitated by an airway endoscopy mask

Fibreoptic bronchoscopy (FB) is frequently associated with a decline in Pao(2), whose degree and duration can be substantial especially in infants. The effect of a face mask, which allows the administration of 100% oxygen and continuous positive airway pressure during FB, on the incidence and severity of hypoxaemia was studied in thirty-one consecutive infants. Sedation was provided by intravenous propofol titrated to allow patient comfort. A transient fall in Spo(2) <95% was recorded in 6/31 patients during endoscopy of the upper airway (lasting 1.6 +/- 1.1 min) and in 11/31 patients during endoscopy of the lower airways (lasting 1.4 +/- 1.1 min). Capillary blood gas analysis before and after endoscopy of the lower airways demonstrated an increase in the PCO2 6.4 +/- 1.3 to 7.3 +/- 1.4 kPa (49 +/- 10 to 56 +/- 11 mmHg). The risk of hypoxaemia in sedated infants breathing spontaneously is low when 100% oxygen and continuous positive airway pressure are administered during FB.