Posture influences patient cough rate, sedative requirement and comfort during bronchoscopy An observational cohort study 英文参考文献.docVIP
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Posture influences patient cough rate, sedative requirement and comfort during bronchoscopy An observational cohort study 英文参考文献
Lingetal.Cough2011,7:9
/content/7/1/9
Cough
RESEARCH
OpenAccess
Postureinfluencespatientcoughrate,sedative
requirementandcomfortduringbronchoscopy:
Anobservationalcohortstudy
IvanTLing*,FrancescoPiccolo,SiobhainAMulrennanandMartinJPhillips
Abstract
Objectives:Toinvestigatedifferencesbetweensemi-recumbentandsupineposturesintermsofcoughrate,
oxygendesaturation,sedativeuse,andpatientcomfortduringtheinitialphaseofbronchoscopy.
Methods:Consecutivebronchoscopypatients(n=69)participatedinthisobservationalcohortstudy.Posturewas
determinedbythebronchoscopist’susualpractice.Patientdemographics,spirometry,pulse,andSpO2were
recorded.Theinitialphasewasdefinedasthetimefrombronchoscopyinsertiontovisualisationofbothdistal
mainbronchi.Coughrate,peakpulse,nadirSpO2,oxygensupplementation,andsedativeuseduringtheinitial
phasewererecorded.Apost-procedurequestionnairewasadministeredtothepatientandtheattendingnurse.
Results:36patientshadbronchoscopyinthesemi-recumbentposture,33inthesupineposture.3of5
bronchoscopistsperformedinbothpostures.Therewerenodifferencesinbaselineparametersbetweenthe
groups.Thesemi-recumbentpostureresultedinsignificantlylesscough(mean(SD)3.6(2.3)vs.6.1(4.5)coughs/
min,p=0.007)andlessfentanyluse(70(29)vs.88(28)mcg,p=0.011)intheinitialphase.Therewereno
significantdifferencesinthenadirSpO2,fallinSpO2,oxygensupplementation,orincreaseinpulseratebetween
thegroups.On100mmvisualanaloguescale,nurseperceptionofpatientdiscomfortwaslowerinthesemi-
recumbentposition(23(21)vs.39(28)mm,p=0.01),andtherewasatrendtowardslesspatientperceivedcough
inthesemi-recumbentgroup(28(25)vs.40(28)mm,p=0.06).
Conclusions:Bronchoscopyperformedinthesemi-recumbentpostureresultsinlesscoughandsedative
requirement,andmayimprovepatientcomfort.
Keywords:bronchoscopy,posture,cough,sedation,hypoxia
Background
Hypoxemiaisknowntooccurduringflexiblebroncho-
Diagnostic flexible bronchoscopy is a common proce- scopy[6-8].Itislikelythatanumberofmechanismscon-
dureperformedforawidevariety ofindications. Itha
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