Management of hypoxemia during flexible bronchoscopy

Oxygen desaturation. is known to occur during flexible bronchoscopy. Significant hypoxemia may sometimes occur during flexible bronchoscopy despite the use of supplemental oxygen. The common causes of hypoxemia during bronchoscopy include upper airway obstruction, bronchoalveolar lavage, oversedation, and hypoventilation. Upper airway obstruction is successfully treated with nasopharyngeal tube insertion. Other strategies that may need to be implemented include oxygen supplementation with intratracheal catheter, reversal of sedation, removal of the bronchoscope, bag and mask ventilation, and, rarely, endotracheal intubation and ventilation. Hypoxemia may last for a considerable time after bronchoscopy has been completed and hence oxygen supplementation should be continued in the recovery room following the procedure.