Skip to main content

ORIGINAL RESEARCH article

Front. Med.
Sec. Pulmonary Medicine
Volume 11 - 2024 | doi: 10.3389/fmed.2024.1409160

Increased risk of respiratory events during endobronchial ultrasound examination in patients with reduced forced expiratory volume: a prospective observational study

Provisionally accepted
Achim Grünewaldt Achim Grünewaldt *Gernot Rohde Gernot Rohde
  • University Hospital Frankfurt, Frankfurt, Germany

The final, formatted version of the article will be published soon.

    Background: The incidence of adverse events during endobronchial ultrasound is low. Nevertheless, it is unclear, whether patients with impaired pulmonary function have an increased risk of respiratory events during the intervention. Methods: A monocentric prospective observational study was performed at the Department of Respiratory Medicine , University Hospital Frankfurt/Main, Germany. Adult patients undergoing an endobronchial ultrasound examination with propofol-sedation were included. Pre-interventional screening included pulmonary function testing, laboratory tests and electrocardiogram. The occurrence of hypercapnia greater than 55 mmHg or reduced oxygen saturation less than 85% was defined as a respiratory event was recorded and compared between patients with normal and impaired pulmonary function tests. Results: In total, 126 patients were included. Pulmonary function testing revealed a median FEV1 of 2.2 l (range 0.4-6.04l) and a predicted FEV1 of 79.5% (range 20-127.8%) respectively. The median FVC was 3.0 l (range 0.87-7.28l), the median predicted FVC was 82% (range 31.4-128.4%). In 72 examinations (60 %) pCO2 levels > 55 mmHg were measured. Transient oxygen desaturation < 85% occurred in 31 cases (25.8%). The Mann Whitney U-test showed a significantly lower FEV1 (% predicted value) in patients with respiratory events (p=0.007). ROC analysis identified a predicted FEV1 of 78.5% as the optimal cut-off with a sensitivity of 58% and a specificity of 71%. Using Z-score instead of predicted values, there was no significant association between a lower Z- score of FEV or FVC and hypercapnic or hypoxic events. However, both a lower absolute value of FEV1/FVC and a lower Z-score of the FEV1/FVC index were associated with the occurrence of respiratory events. In binary logistic regression analysis, we could not demonstrate any association with other relevant parameters (age, BMI, sedation dosage, sedation duration or ASA-score). Conclusions: An impaired forced expiratory volume is associated with the frequency of respiratory events during endobronchial ultrasound examination under propofol-sedation.

    Keywords: Endobronchial ultrasound, Monitoring, sedation, Hypercapnia, desaturation

    Received: 29 Mar 2024; Accepted: 17 Jul 2024.

    Copyright: © 2024 Grünewaldt and Rohde. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Achim Grünewaldt, University Hospital Frankfurt, Frankfurt, Germany

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.