Clinical Efficacy and Safety of Mechanical Ventilation Combined with Fiberoptic Bronchoalveolar Lavage in Patients with Severe Pulmonary Infection

Wang, Chunya; Yu, Sha; Wang, Xiaochuang; Zhao, Yujie; Ma, Qiang; Wang, Li

doi:10.12659/msm.915507

Cited by 6 publications

(3 citation statements)

References 26 publications

(27 reference statements)

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“…The establishment of an artificial airway in an ICU patient results in the disappearance of the natural barrier of the upper respiratory tract and direct communication of the lower respiratory tract with the outside air. Various invasive medical procedures potentially increase the risk of infection in the lower respiratory tract [28]. The establishment of the artificial airway opens the respiratory pathway for the patient, but long-term mechanical ventilation and open-ended invasive procedures such as suction and fiberoptic bronchoscopy increase the incidence of VAP [29].…”

Section: Discussionmentioning

confidence: 99%

What we can do? The risk factors for multi-drug resistant infection in pediatric intensive care unit (PICU): a case-control study

Wang

Xia

2020

Ital J Pediatr

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Background: The risk factors for multi-drug resistant infection (MDRI) in the pediatric intensive care unit (PICU) remain unclear. It's necessary to evaluate the epidemiological characteristics and risk factors for MDRI in PICU, to provide insights into the prophylaxis of MDRI clinically.Methods: Clinical data of 79 PICU children with MDRI were identified, and 80 children in PICU without MDRI in the same period were selected as control group. The related children's characteristics, clinical care, microbiologic data, treatments provided, and outcomes of the patients with were reviewed and collected. Univariate and multivariate logistic regression analyses were performed to identify the potential risks of MDRI in PICU. Results: Of the diagnosed 79 cases of MDRI, there were28 cases of CR-AB, 24 cases of MRSA, 22 cases of PDR-PA,3 cases of VRE and 2 cases of CRE respectively. Univariate analyses indicated that the length of PICU stay, the duration of mechanical ventilation > 5 days, parenteral nutrition, coma, urinary catheter indwelling, invasive operation, 2 or more antibiotics use were associated with MDRIs (all p < 0.05); The logistic multiple regression analyses indicated that coma, parenteral nutrition, 2 or more antibiotics use and the duration of mechanical ventilation > 5 days were independent risk factors associated with MDRI (all p < 0.05).Conclusions: This present study has identified several potentially modifiable risk factors for MDRI in PICU, it's conducive to take appropriate measures targeting risk factors of MDRI for health care providers to reduce MDRI.

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Section: Discussionmentioning

confidence: 99%

What we can do? The risk factors for multi-drug resistant infection in pediatric intensive care unit (PICU): a case-control study

Wang

Xia

2020

Ital J Pediatr

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“…According to previous studies, the application of high-dose AH significantly improves the therapeutic effect on pulmonary infection without obvious adverse reactions [ 15 ]. BAL with a bronchoscope can directly enter the diseased region and remove inflammatory secretions in the region, thus reducing airway resistance and respiratory consumption, increasing the blood oxygenation level of the pulmonary alveolus, and improving pulmonary function [ 16 ]. In our study, AH can directly reach the diseased region through BAL, further improving the efficiency of treatment.…”

Section: Discussionmentioning

confidence: 99%

Effects of Bronchoalveolar Lavage with Ambroxol Hydrochloride on Treating Pulmonary Infection in Patients with Cerebral Infarction and on Serum Proinflammatory Cytokines, MDA and SOD

Meng

Cheng

Sang

et al. 2020

Computational and Mathematical Methods in Medicine

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Objective. This paper was aimed at investigating the effects of bronchoalveolar lavage (BAL) with ambroxol hydrochloride (AH) on treating pulmonary infection and on serum proinflammatory cytokines and oxidative stress responses in patients with cerebral infarction (CI). Methods. One hundred and two patients with cerebral infarction complicated with pulmonary infection (CIPI) who were treated in our hospital were enrolled as research objects, divided into an observation group (52 cases; AH combined with BAL) and a control group (50 cases; single AH) based on therapeutic schemes. They were compared in terms of the therapeutic effect and pre- and posttreatment serum inflammatory cytokines, pulmonary function, and serum indices of oxidative stress. Their adverse reactions during treatment were also recorded and compared. Results. The therapeutic effect in the observation group was remarkably better than that in the control group (P<0.05). After treatment, the serum inflammatory cytokines, pulmonary function, and serum indices of oxidative stress were remarkably improved in the two groups (P<0.05), but the improvement was remarkably better in the observation group (P<0.05). The differences were not significant in intratreatment adverse reactions between the two groups (P>0.05). Conclusion. For CIPI patients, BAL with AH has a better therapeutic effect and higher safety and can control the patients’ systemic inflammatory responses and oxidative stress responses, so it is worthy of further promotion in clinical practice.

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“…Our analysis showed that B-ACT could improve some important laboratory results including some inflammatory factors (CRP and PCT), routine blood parameters (WBC# and N%) and blood gas analysis (PO 2 and SO 2 ). Consistent with our results, a retrospective study admitting 81 SP patients with IMV reported that not only inflammation indicators including tumor necrosis factor-a (TNF-α), CRP, IL-8 and IL-6 but also blood gas indexes including PO 2 and SO 2 were significantly better in the bronchoalveolar lavage (BAL) group than those in the control group after bronchoscopy, in which hospital stay, IMV time, and infection control window appearance time in the observation group were significantly shorter than those in the control group after bronchoscopy (all p < 0.05) [15]. Moreover, a prospective study enrolling 103 SP patients including patients with IMV demonstrated that the changes of APACHE II scores, inflammatory indicators (CRP, TNF-αand PCT) and blood gas analysis (oxygenation index (OI), PO 2 and SO 2 ) in the bronchoscopy group were more pronounced than those in the control group after treatment, and the length of stay in ICU, IMV time and duration of antibiotics of the bronchoscopy group were shorter than those of the control group after treatment (all p < 0.05) [16].…”

Section: Discussionmentioning

confidence: 99%

Brochoscopic Airway Clearance Therapy vs. Conventional Sputum Aspiration: The Future of Flexible Brochoscopes in Intensive Care Units?

Yao,

Liu,

et al. 2023

Diagnostics

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(1) Background: The aim of our study is to investigate the effectiveness of bronchoscopic airway clearance therapy (B-ACT) on severe pneumonia (SP) patients with invasive mechanical ventilation (IMV) in the intensive care unit (ICU). (2) Methods: Our study retrospectively enrolled 49 patients with sputum aspiration and 99 patients with B-ACT, and the latter were divided into the ≤once every 3 days group (n = 50) and >once every 3 days group (n = 49). (3) Results: We found most laboratory blood results were significantly improved in the B-ACT group as compared with those in sputum aspiration group (p < 0.05). Patients in the B-ACT group and those in ≤once every 3 days group also had significantly better survival to hospital discharge than those in their counterpart groups (Logrank p < 0.001). In patients with cardiopulmonary diseases or positive cultures for bacteria, the B-ACT group and those in the ≤once every 3 days group had significantly better survival outcomes to discharge than those in their counterpart groups (Logrank p < 0.001). B-ACT and the average frequency of ≤once every 3 days had significantly better impact on survival outcomes than their counterpart groups (HR: 0.444, 95% CI: 0.238–0.829, p = 0.011; HR: 0.285, 95% CI: 0163–0.498, p < 0.001). (4) Conclusions: In the future, flexible bronchoscopes may paly an important role in ACT for SP patients with IMV.

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Clinical Efficacy and Safety of Mechanical Ventilation Combined with Fiberoptic Bronchoalveolar Lavage in Patients with Severe Pulmonary Infection

Cited by 6 publications

References 26 publications

What we can do? The risk factors for multi-drug resistant infection in pediatric intensive care unit (PICU): a case-control study

What we can do? The risk factors for multi-drug resistant infection in pediatric intensive care unit (PICU): a case-control study

Effects of Bronchoalveolar Lavage with Ambroxol Hydrochloride on Treating Pulmonary Infection in Patients with Cerebral Infarction and on Serum Proinflammatory Cytokines, MDA and SOD

Brochoscopic Airway Clearance Therapy vs. Conventional Sputum Aspiration: The Future of Flexible Brochoscopes in Intensive Care Units?

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