High Flow Nasal Oxygen during Endobronchial Ultrasound to prevent low oxygen levels.

Endobronchial ultrasound (EBUS) is a procedure performed to extract tissue from the lung to aid diagnosis of lung cancer, infections and sarcoidosis. To tolerate this procedure, which involves a camera on a tube being inserted into the lung, patients require sedation. The sedative medications commonly cause patients to hypoventilate, and a reduction in oxygen saturation and increase in carbon dioxide level is commonly seen, necessitating the interruption of the procedure, and occasionally putting patient’s lives at risk. An intervention to reduce the rates of these problems may make the procedure safer. The OptiFlow THRIVE device delivers high flow oxygen via the nose, and may reduce the rate of desaturation and limit the rate of increase in CO2 level. The device has been trialed in anaesthesia in morbid obesity surgery, difficult airways in ENT and during awake fibreoptic intubation, which is a conceptually similar procedure to EBUS. The device has been used safely for many years to assist intubation in the emergency department and intensive care unit. There is no data currently using the device during EUBS, or any endoscopic procedure for that matter. This study will randomize participants to either oxygen therapy during sedation with standard care (being a gutter mask) or OptiFlow THRIVE. The research question is: In adults undergoing endobronchial ultrasound, does oxygen therapy provided using the OptiFlow THRIVE device reduce the frequency of desaturation and hypercarbia compared to standard oxygen therapy using a gutter mask?