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The current practice of oxygenation and/or ventilation supports in patients undergoing Fiberoptic Bronchoscopy is very heterogeneous among studies published in the literature; in addition, clear outcomes advantages of one strategy over another currently lack.
The goal of this observational study is to describe the current practice of oxygenation and/or ventilation supports in patients undergoing Fiberoptic Bronchoscopy (FOB), stratified by baseline respiratory condition, co-morbidities, type of procedure and hospital settings.
Investigators will enroll all adult patients undergoing any fiberoptic bronchoscopy in any clinical settings (from outpatients to critically ill patients). No specific exclusion criteria are indicated for enrollment in this study.
Investigators will record the following data:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Standard Oxygen Therapy (SOT) | Patients receiving low oxygen flow administration through nasal prongs, oxygen mask with or without reservoir, and Venturi mask. |
| |
| High Flow oxygen through Nasal Cannula (HFNC) | Administration of high flows (up to 60 L/min) of air/oxygen admixtures, heated (at temperatures ranging from 31 to 37°C) and fully humidified (up to 44 mg H2O/L), providing an inspired oxygen fraction ranging from 21 to 100% |
| |
| Continuous Positive Airway Pressure (CPAP) | application of positive end-expiratory pressure (PEEP) throughout the whole respiratory cycle by means of interfaces such as mask or helmet |
| |
| Non-Invasive Ventilation (NIV) | application of a PEEP by means of a mask or helmet, with an inspiratory pressure support triggered by the patient and delivered by a ventilator and through interfaces such as mask or helmet |
| |
| Invasive Mechanical Ventilation (iMV) | application of a ventilatory assistance in controlled or partial assisted modalities through an endotracheal or tracheostomy tube |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Bronchoscopy | Diagnostic Test | Patients will undergo to the bronchial endoscopy procedure required for their clinical condition: toilet bronchoscopy (for secretions, blood, mucus plugs removal), broncho-aspirate (BAS), bronchoalveolar lavage (BAL), brushing for cytology, biopsy, endobronchial ultrasound (EBUS). |
| Measure | Description | Time Frame |
|---|---|---|
| Type of oxygenation strategy adopted | The type of oxygenation strategy (standard oxygen therapy, high flow nasal cannula, continuous positive airway pressure, non invasive ventilation or invasive mechanical ventilation) adopted during the bronchoscopy will be recorded. | Through the endoscopy completion, an average of 30 minutes |
| Measure | Description | Time Frame |
|---|---|---|
| Type of sedation strategy adopted | The type of sedation strategy (topical anesthesia, midazolam, propofol, remifentanil, fentanyl, dexmedetomidine, neuromuscular blocking agents) adopted during the bronchoscopy will be recorded. | Through the endoscopy completion, an average of 30 minutes |
| Lowest peripheral oxygen saturation |
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Inclusion Criteria:
Exclusion Criteria:
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We will include all adult patients requiring a flexible bronchoscopy for diagnostic or procedural reasons from all possible settings (from outpatients in dedicated ambulatories to patients admitted in any hospital ward or Intensive Care Unit)
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Federico Longhini, MD | Contact | +393475395967 | longhini.federico@gmail.com |
| Name | Affiliation | Role |
|---|---|---|
| Federico Longhini, MD | Magna Graecia University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| AOU Mater Domini | Recruiting | Catanzaro | Italy |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 40897500 | Derived | Longhini F, Crimi C, Noto A, Pelaia C, Karakurt Z, Skoczynski S, Boleo-Tome JP, Winck JC, Esquinas AM, Melhorn J, Corneci D, Pobeha P, Bosco V, Garofalo E, Bruni A, Cammarota G, Todorova V, Puci MV, Sotgiu G, Kostikas K, Maggiore SM, De Robertis E, Ergan B, Landoni G, Simonte R, Nava S, Navalesi P, Scala R; OxyFOB study group. Practice of oxygenation and respiratory support during fibreoptic bronchoscopy: the OxyFOB study protocol. BMJ Open. 2025 Sep 2;15(9):e104747. doi: 10.1136/bmjopen-2025-104747. |
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Anonymous data will be shared after study publication on a peer-reviewed journal in english language, on a reasonable request to the principal investigator
After study publication on a peer-reviewed journal in english language
On reasonable request to the Principal Investigator
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| ID | Term |
|---|---|
| D011014 | Pneumonia |
| D008175 | Lung Neoplasms |
| D011658 | Pulmonary Fibrosis |
| D017563 | Lung Diseases, Interstitial |
| ID | Term |
|---|---|
| D012141 | Respiratory Tract Infections |
| D007239 | Infections |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
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| ID | Term |
|---|---|
| D001999 | Bronchoscopy |
| ID | Term |
|---|---|
| D003948 | Diagnostic Techniques, Respiratory System |
| D019937 | Diagnostic Techniques and Procedures |
| D003933 | Diagnosis |
| D004724 | Endoscopy |
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|
The lowest peripheral oxygen saturation recorded during the procedure |
| Through the endoscopy completion, an average of 30 minutes |
| Lowest heart rate | The lowest heart rate recorded during the procedure | Through the endoscopy completion, an average of 30 minutes |
| Highest heart rate | The highest heart rate recorded during the procedure | Through the endoscopy completion, an average of 30 minutes |
| Lowest systolic blood pressure | The lowest systolic blood pressure recorded during the procedure | Through the endoscopy completion, an average of 30 minutes |
| Highest systolic blood pressure | The highest systolic blood pressure recorded during the procedure | Through the endoscopy completion, an average of 30 minutes |
| Duration of the procedure | The time duration of the procedure in minutes, from the beginning to the end of the endoscopy procedure | From the beginning to the end of the endoscopy procedure |
| Desaturation events | Occurrence of peripheral oxygen saturation < 90% for at least 10 seconds | Through the endoscopy completion, an average of 30 minutes |
| Severe desaturation events | Occurrence of peripheral oxygen saturation < 80% | Through the endoscopy completion, an average of 30 minutes |
| Hypotensive events | Occurrence of systolic blood pressure <90 mmHg | Through the endoscopy completion, an average of 30 minutes |
| Hypertensive events | Occurrence of systolic blood pressure >140 mmHg | Through the endoscopy completion, an average of 30 minutes |
| Need for support escalation | Need to escalate the oxygenation/ventilation support from from standard oxygen therapy (lowest support) to High Flow Nasal Cannula, Continuous Positive Airway Pressure, Non Invasive Ventilation or invasive Mechanical Ventilation (highest grade of support) | Through the endoscopy completion, an average of 30 minutes |
| Admission to ward or intensive care unit | Need for admission to ward or intensive care unit after the endoscopy completion | At the end of the endoscopy completion, after an average of 30 minutes from study start |
| D012142 |
| Respiratory Tract Neoplasms |
| D013899 | Thoracic Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D005355 | Fibrosis |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D003949 | Diagnostic Techniques, Surgical |
| D019060 | Minimally Invasive Surgical Procedures |
| D013514 | Surgical Procedures, Operative |
| D013510 | Pulmonary Surgical Procedures |
| D019616 | Thoracic Surgical Procedures |