Table 2.

Anesthesia recommendations for advanced guided bronchoscopy. Adapted from Pritchett et al. [38].

Procedural Step	Recommendations
Pre-Oxygenation	Avoid FiO2 of 1.0 and use a lower FiO2 of 0.6–0.8.
Anesthesia Type	TIVA with Propofol and paralytics.
Intubation	Use larger endotracheal tube if able (≥8.5 mm). Use non-depolarizing muscle relaxant.
Post-Intubation	Perform 4 recruitment maneuvers as able. Maintain FiO2 at lowest tolerated level for saturations of above 90% with PEEP up to 10–12 cm H2O. Use a tidal volume of 8–10 cc/Kg of ideal body weight.
Breath Hold	Peak inspiratory breath hold. Adjust APL valve to maintain circuit pressure at desired PEEP for 5–10 s before beginning advanced imaging sweep.
Biopsy	Ensure ventilator settings are the same as those when performing sweep.

APL: adjustable pressure-limiting valve, FiO₂: fraction of inspired oxygen, PEEP: positive end expiratory pressure, TIVA: total intravenous anesthesia.