Flexible Bronchoscopy in Supine or Sitting Position A Randomized Prospective Analysis of Safety and Patient Comfort

摘要

Background: Flexible bronchoscopy is performed under many different conditions (sitting/supine position, with or without oxygen prophylaxis) in different hospitals according to local traditions. Objectives: The study was to investigate the effect of different patient positions in flexible bronchoscopy on patient comfort and safety. Methods: We started a prospective randomized controlled trial to compare bronchoscopy in supine and sitting positions. Consecutive outpatients undergoing regular diagnostic bronchoscopy were included and randomly selected to be in a supine or sitting position. A self-administrated questionnaire was taken from the patients after the bronchoscopy and the answers were evaluated. A total of 107 patients were included; 46 underwent bronchoscopy in the supine position. Results: Of all patients, 52% showed a decrease in oxygen saturation of more than 4%. The sitting position is a risk factor for oxygen decline, with a relative risk of 2.46. Conclusions: We recommend performing the procedure while the patient is in a supine position. We also recommend routine prophylactic low-flow supplemental oxygen in all patients undergoing bronchoscopy.