{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T11:29:47Z","timestamp":1780399787692,"version":"3.54.1"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Deep sedation for flexible bronchoscopy (FB) improves procedural conditions but exacerbates desaturation risks. High-flow nasal cannula (HFNC) may mitigate this situation, yet efficacy under deep sedation remains unproven.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this randomized trial (ChiCTR2400083597), 340 ASA I-II patients undergoing FB under deep sedation (MOAA\/S\u202f\u2264\u202f1) received conventional nasal cannula (5\u202fL\/min; NC) or HFNC (25\/45\/65\u202fL\/min). The primary outcomes were the incidence of intraoperative desaturation (SpO\u2082\u202f&amp;lt;\u202f90%\u202f&amp;gt;\u202f10s) and intraoperative nadir SpO\u2082 value. The intraoperative VAS scores for cough that reflect the stimulation inhibition as a result of deep sedation were used as secondary outcome. Other evaluated outcomes included the EtCO\u2082 values before induction and after awakening, incidence of intraoperative hypertension\/hypotension, postoperative adverse events, as well as the willingness to undergo re-examination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      All procedures were completed in approximately 5\u202fmin, without requiring the application of laryngeal mask airway or endotracheal intubation. HFNC groups showed significantly lower desaturation incidence (HF25:16.87%, HF45:12.05%, HF65:5.00%) versus NC (57.14%,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.000), with weak flow-dependence. All HFNC cohorts maintained higher nadir SpO\u2082 (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.000) and reduced CO\u2082 retention versus NC (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05). Cough scores were uniformly low (median VAS:1\u20131.5), with &amp;gt;97% willingness for repeat FB.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The application of HFNC can markedly lower the risks of desaturation during FB under deep sedation in a weak flow-dependent manner, while partially mitigating carbon dioxide accumulation, enabling safer deep sedation without intubation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2025.1729660","type":"journal-article","created":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T06:36:01Z","timestamp":1767854161000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["High-flow nasal cannula oxygenation reduces desaturation risk during diagnostic flexible bronchoscopy under deep sedation: a randomized controlled trial"],"prefix":"10.3389","volume":"12","author":[{"given":"Ming","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Longfei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuefei","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wanquan","family":"Ming","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng","family":"Sheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rong","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Youhua","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongbin","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yonghua","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunfei","family":"Cao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,8]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"i1","DOI":"10.1136\/thoraxjnl-2013-203618","article-title":"British 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