The benefit of daily sputum suction via bronchoscopy in patients of chronic obstructive pulmonary disease with ventilators: A randomized controlled trial

BACKGROUND: To compare the clinical values of bronchoscopic sputum suction and general sputum suction in respiratory failure patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) combined with sequential invasive–noninvasive mechanical ventilation at the pulmonary infection control (PIC) window (period of lower sputum production, with thinner viscosity and lighter color, and alleviated clinical signs of infection). METHODS: Patients with AECOPD-induced respiratory failure received orotracheal intubation mechanical ventilation and were randomly divided into bronchoscopic sputum suction group or general sputum suction group, and who were then treated with sequential invasive–noninvasive mechanical ventilation at PIC window (both groups). Baseline data, postoperative blood gas conditions, and postoperative clinical parameters of the patients such as appearance of PIC window, time of invasive ventilation, total time of ventilation, hospital stay, weaning success rate, reintubation rate, ventilator-associated pneumonia (VAP) incidence, and fatality rate were measured to compare the effect of 2 different ways of sputum suction. RESULTS: There was no significant difference in baseline characteristics, postoperative blood gas conditions, between 2 groups (all P > .05). Nevertheless, the bronchoscopic sputum suction group showed earlier appearance of PIC window, shorter time of invasive ventilation, total time of ventilation and hospital stay, lower reintubation rate, VAP incidence and fatality rate, and higher weaning success rate than the general sputum suction group (all P < .05). CONCLUSION: Bronchoscopic sputum suction combined with sequential invasive–noninvasive mechanical ventilation at PIC window showed clinical effects in treating respiratory failure patients with AECOPD.