Frontiers in medicine · 2026
A comparative study of conventional, High-flow, and jet ventilation via the Wei nasal jet tube for oxygen therapy in patients undergoing bronchoscopic intervention under deep sedation: a randomized controlled trial.
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Zhang Ai-Di, Ge Xiang, Li Xiao-Li, Cheng Qing-Hao, Yang Ming-Yuan
Аннотация
BACKGROUND: Hypoxemia is a frequent complication in the bronchoscopic interventions (BI) under deep sedation due to shared airway challenges. The Wei nasal jet tube (WNJ) enables supraglottic jet oxygenation and ventilation (SJOV) without tracheal intubation, but its efficacy and safety compared to conventional oxygen therapy (COT) or high-flow nasal cannula (HFNC) in patients with mild-to-moderate airway stenosis remain unclear.
METHODS: In the prospective randomized controlled trial, 150 patients through BI under deep sedation were allocated to three groups: COT (fractional inspired oxygen (FiO2 1.0, 10 L/min), HFNC (FiO2 1.0, 40 L/min), or SJOV via WNJ (FiO2 1.0, driving pressure 0.6 bar, respiratory rate 600 cycles/min). Primary outcomes included the incidence of intraoperative hypoxemia (SpO2 < 90%), severe hypoxemia (SpO2 < 80%), the requirement for mask positive-pressure oxygenation (MPPO) and endotracheal intubation. Arterial blood gas parameters, hemodynamic variables, adverse events and procedure duration were also analyzed.
RESULTS: A sum of 150 patients participated in the study. The incidences of hypoxemia, severe hypoxemia, and MPPO were compared among the three groups. The overall incidence of hypoxemia differed significantly (P = 0.020), with the SJOV group showing a lower rate than the COT group (P = 0.018). The overall incidence of severe hypoxemia differed significantly among groups (P = 0.024), SJOV showed a notably reduced incidence compared to COT (P = 0.016). MPPO incidence varied significantly among groups (P = 0.022). SJOV showed a lower rate than COT (P = 0.014). PaO2 was significantly higher in the SJOV group compared to both the COT and HFNC groups (P < 0.001 for both). The SJOV group exhibited significantly lower lactic acid levels than both the COT group (P < 0.001) and the HFNC group (P = 0.006). No significant differences were observed in endotracheal intubation, PaCO2, pH, hemodynamic stability, total propofol and remifentanil consumption, adverse events or procedure duration among groups.
CONCLUSION: SJOV delivered via the Wei nasal jet tube improved intraoperative oxygenation and reduced hypoxemia compared with COT during bronchoscopic intervention under deep sedation, without increasing adverse events. These findings support SJOV as a feasible oxygenation and ventilation strategy for selected patients with mild-to-moderate airway stenosis.
CLINICAL TRIAL REGISTRATION: https://www.chictr.org.cn/searchproj.html, identifier ChiCTR2100054123.
METHODS: In the prospective randomized controlled trial, 150 patients through BI under deep sedation were allocated to three groups: COT (fractional inspired oxygen (FiO2 1.0, 10 L/min), HFNC (FiO2 1.0, 40 L/min), or SJOV via WNJ (FiO2 1.0, driving pressure 0.6 bar, respiratory rate 600 cycles/min). Primary outcomes included the incidence of intraoperative hypoxemia (SpO2 < 90%), severe hypoxemia (SpO2 < 80%), the requirement for mask positive-pressure oxygenation (MPPO) and endotracheal intubation. Arterial blood gas parameters, hemodynamic variables, adverse events and procedure duration were also analyzed.
RESULTS: A sum of 150 patients participated in the study. The incidences of hypoxemia, severe hypoxemia, and MPPO were compared among the three groups. The overall incidence of hypoxemia differed significantly (P = 0.020), with the SJOV group showing a lower rate than the COT group (P = 0.018). The overall incidence of severe hypoxemia differed significantly among groups (P = 0.024), SJOV showed a notably reduced incidence compared to COT (P = 0.016). MPPO incidence varied significantly among groups (P = 0.022). SJOV showed a lower rate than COT (P = 0.014). PaO2 was significantly higher in the SJOV group compared to both the COT and HFNC groups (P < 0.001 for both). The SJOV group exhibited significantly lower lactic acid levels than both the COT group (P < 0.001) and the HFNC group (P = 0.006). No significant differences were observed in endotracheal intubation, PaCO2, pH, hemodynamic stability, total propofol and remifentanil consumption, adverse events or procedure duration among groups.
CONCLUSION: SJOV delivered via the Wei nasal jet tube improved intraoperative oxygenation and reduced hypoxemia compared with COT during bronchoscopic intervention under deep sedation, without increasing adverse events. These findings support SJOV as a feasible oxygenation and ventilation strategy for selected patients with mild-to-moderate airway stenosis.
CLINICAL TRIAL REGISTRATION: https://www.chictr.org.cn/searchproj.html, identifier ChiCTR2100054123.