Administration of Oxygen

Let us briefly consider the methods of administering oxygen:

  1. Nasal cannula
  2. A mask with a hole made to permit passage of the bronchoscope

I find nasal cannula easy to use. Even with a transnasal bronchoscopy, you can maintain sufficient oxygenation. I do not recall any circumstance when I had to resort to a mask. Even if nasal passages are completely blocked by nasal polyps, I can use the cannula in the mouth.

Two facts are well established:

  1. The PO2 drops approximately 10-20 mm of Hg during the bronchoscopy. The worse drop occurs during saline lavage.
  2. Serious hypoxemia can be prevented by supplemental oxygen therapy.

The oxygen saturation and pulse rate can be monitored with ease using a finger transcutaneous oximeter. We use it routinely. It has helped us avert serious hypoxemia in a few cases. However, routine use of oximeter may not be necessary.