INTRAPLEURAL FOREIGN BODY RETRIEVAL WITH SEMI RIGID THORACOSCOPY UNDER SINGLE LUNG VENTILATION

Background and Aims: Bronchoscopic examination is one of the most important procedures for confirmatory diagnosis and treatment decision-making in lung disease, especially in patients with acute respiratory failure (ARF). However, the optimal method of bronchoscopy for patients with ARF is unknown. Supplemental oxygen is usually administered via nasal cannula during bronchoscopy, but oxygenation in patients with ARF is often unstable and insufficient with conventional methods (such as nasal cannulation), especially during bronchoscopy. To resolve this problem, we previously proposed a simple method of bronchoscopy performed under mask ventilation using the Jackson-Rees circuit (Jackson mask ventilation) for patients with ARF. Here, we examined the usefulness of Jackson mask ventilation in detail as compared with the conventional method. Methods: We retrospectively analyzed patients who developed ARF during bronchoscopy from January 2015 to May 2018, and compared efficacy and safety between the Jackson group and the Conventional group. The Jackson group underwent Jackson mask ventilation for ARF during bronchoscopy. The Conventional group underwent conventional ventilation for ARF. Results and Conclusions: A total of 1,262 patients underwent bronchoscopy; 12 were assigned to the Jackson group and 13 to the Conventional group. In the Jackson group, percutaneous oxygen saturation (SpO2) increased after Jackson mask ventilation (89.4% to 96.8%, P = 0.03). SpO2 during bronchoscopy was significantly higher in the Jackson group than in the Conventional group. (96.8% vs. 95.2%, P = 0.03). Mean oxygen flow rate during bronchoscopy was lower in the Jackson group (4.5 L/min vs. 7.9 L/min, P = 0.0007). There were no differences in terms of safety, such as complications after bronchoscopy, between the two groups. The use of Jackson Mask Ventilation may be well-tolerated and efficacious during bronchoscopy for patients presenting with ARF.