Objective:

To compare the efficacy and safety of supraglottic jet oxygenation and ventilation (SJOV) via the Wei nasal jet tube (WNJ) with conventional oxygen therapy (COT) and high-flow nasal cannula (HFNC) during bronchoscopic procedures under deep sedation in patients with mild-to-moderate airway stenosis.

Approach:

• Study Design: A prospective randomized controlled trial involving 150 patients undergoing bronchoscopic interventions under deep sedation, allocated to three groups: COT, HFNC, or SJOV.

Key Findings:

• The SJOV group had a significantly lower incidence of hypoxemia compared to COT (P = 0.018).
• The SJOV group showed a significantly reduced incidence of severe hypoxemia compared to COT (P = 0.016).
• The SJOV group required mask positive-pressure oxygenation (MPPO) less frequently than COT (P = 0.014).
• PaO2 levels were significantly higher in the SJOV group compared to both COT and HFNC (P < 0.001).
• Lactic acid levels were significantly lower in the SJOV group compared to COT (P < 0.001) and HFNC (P = 0.006).

Interpretation:

SJOV delivered via the Wei nasal jet tube improves intraoperative oxygenation and reduces hypoxemia compared to COT during bronchoscopic interventions under deep sedation, without increasing adverse events.

Limitations:

• The study was conducted at a single center, which may limit generalizability.
• No interim analyses were performed, and no protocol modifications were made after trial initiation.

Conclusion:

SJOV is a feasible oxygenation and ventilation strategy for selected patients with mild-to-moderate airway stenosis during bronchoscopic procedures.

Sources:

• Clinical Trial Registration