Controlled supplemental oxygenation during tracheobronchial hygiene

The effect of controlled supplemental oxygenation without bag ventilation on transcutaneous partial pressure of oxygen (TcPO₂) measurements during tracheobronchial hygiene was evaluated. Procedure A, no supplemental oxygenation, was compared to Procedure B, in which controlled supplemental oxygenation was used. For controlled supplemental oxygenation, the FiO₂ was increased until TcPO₂ measurements 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 TcPO₂ was observed during chest vibration, and further decrease in TcPO₂ was noted with endotracheal suctioning. Except for baseline readings, throughout the tracheobronchial hygiene TcPO₂ measurements were significantly higher and more subjects maintained TcPO₂ values greater than 40 torr in Procedure B. In Procedure A corresponding TcPO₂ measurements were 40 torr or less. Mean recovery time was shorter in Procedure B, 2.1 ± 2.3 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.