{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T03:43:52Z","timestamp":1788320632131,"version":"build-2803163510"},"reference-count":122,"publisher":"S. Karger AG","issue":"1","license":[{"start":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T00:00:00Z","timestamp":1757980800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T00:00:00Z","timestamp":1757980800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Respiration"],"abstract":"<jats:p>Introduction: Sedation during flexible bronchoscopy can be administered by a second physician, an anesthesiologist or as nurse-administered sedation (NAS). Propofol is often administered by non-anesthesiologists. It is unclear whether complications differ with various sedation protocols. Methods: We searched PubMed for clinical trials of sedation during bronchoscopy and conducted a systematic review of complications (death \u226424 h post-procedure or intensive care unit (ICU) admission\/predefined cardiopulmonary escalation [CPE]). Outcomes were analyzed according to the staff administering sedation, complexity of procedure, for propofol-containing regimes, and the ASA physical status classification of the patient. Results: This analysis (120 articles, 39,475 procedures) showed a mortality rate of 0.01% for sedation bronchoscopy. ICU admission rate was 0.12%, and CPE was reported in 0.57%. Significantly higher CPE was recorded for anesthesiologists compared to NAS and second physicians (1.16% vs. 0.65% vs. 0.07%, respectively, p &lt; 0.001) with higher ICU admission for NAS compared to anesthesiologists and second physicians (0.35% vs. 0.00% vs. 0.03%, respectively, p &lt; 0.001). Endobronchial ultrasound did not increase complication rates. Admission to ICU and CPE remained &lt;1% in propofol-containing regimes, although complications were slightly lower without propofol. Comparison of lower risk ASA 1\u20132 studies compared to studies with ASA 1\u20133 showed no significant difference in outcome. Conclusion: Sedation bronchoscopy is a safe procedure. The staff administering sedation may react differently to periprocedural respiratory and cardiovascular events. Propofol application is not associated with a clinically relevant increase in complication rate. There is no evidence that ASA status is a predictor of individual risk at bronchoscopy.<\/jats:p>","DOI":"10.1159\/000548435","type":"journal-article","created":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T16:01:00Z","timestamp":1758038460000},"page":"37-56","source":"Crossref","is-referenced-by-count":4,"title":["A Systematic Review of the Safety of Sedation during Flexible 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