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Application of bedside bronchoscopy in the management of chronic obstructive pulmonary disease com-plicated with respiratory failure
Author(s): Yan Yusheng, Tang Yuling
Pages: 395-
398
Year: 2015
Issue:
6
Journal: New Chinese Medicine
Keyword: Bedside bronchoscopy; Noninvasive positive pressure ventilation; Chronic obstructive pulmonary disease; Respiratory failure;
Abstract: Objective To observe the clinical efficacy of bedside bronchoscopy in the treatment of chronic obstructive pulmonary disease (COPD)complicated with respiratory failure.Methods Sixty cases de-veloping acute exacerbation of COPD (AECOPD)complicated with respiratory failure were randomly assigned into the treatment (n =28)and control groups (n =32).Patients in the control group received routine treat-ment,such as oxygen inhalation,administering antispasmodics,antitussive and expectorant,anti-infection and noninvasive positive pressure ventilation,etc.Beside conventional management,patients in the treatment group underwent bedside bronchoscopy (fiberoptic bronchoscopy).Sputum sample was collected for bacterial culture. Blood gas changes,duration of noninvasive positive pressure ventilation,success rate,qualified and positive rates of sputum samples were observed before and after treatment in both groups.Results Among 28 cases in the treatment group,25 (89%)were recovered by routine therapy combined with bedside bronchoscopy,sig-nificantly higher compared with 63% in the control group (P <0.05).After respective treatment,significant improvement in blood gas levels was noticed in both groups,especially in the treatment group (both P <0.05) .The qualified and positive rates of sputum sampling in the treatment group were 96% and 79%,significantly higher than 75% and 53% in the control group (both P <0.05).The duration of noninvasive positive pressure ventilation and length of hospital stay in the treatment group were considerably shortened compared with those in the control group (both P <0.01 ).Conclusions Application of bedside bronchoscopy significantly improves ventilation,enhances qualified rate of sputum sample and contributes to selection of proper treatment and clini-cal prognosis of AECOPD patients.
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