Controlled supplemental oxygenation during tracheobronchial hygiene

The effect of controlled supplemental oxygenation without bag ventilation on transcutaneous partial pressure of oxygen (TcPO₂) measurements during tra-cheobronchial hygiene was evaluated. Procedure A, no supplemental oxygena-tion, was compared to Procedure B, in which controlled supplemental oxygena-tion was used. For controlled supple-mental oxygenation, the FiO₂was in-creased until TcPO₂measurements rose to levels between 90 and 100 torr. Sixteen premature infants who required mechanical ventilation were studied in the neonatal center. Both procedures were performed on each patient in random order. In both procedures, a precipitous decrease in TCPO₂was observed during chest vibration, and further decrease in TCPO₂was noted with'endotracheal suctioning. Except for baseline readings, throughout the tracheobronchial hygiene TCPO₂measurements were significantly higher and more subjects maintained TcPO₂values greater than 40 torr in Procedure B. In Procedure A corresponding TCPO₂measurements were 40 torr or less. Mean recovery time was shorter in Procedure B, 2.1 ± 2.3 minutes, than in Procedure A, 4.9 ± 2.8 minutes, p <.003. Thus, in most patients, controlled supplemental oxygenation without manual bag ventilation seems sufficient to prevent hypoxia during tracheobronchial hygiene; it also shortens recovery time from hypoxemia as a result of the bronchopulmonary hygiene procedure.