Effectiveness of prone ventilation combined with fiberoptic bronchoscopy and alveolar lavage in treating severe pneumonia with acute respiratory failure
ZOU Xiao-fen
CHEN Yu-chong
PAN Ting-jun
LUO Wei-wen
YANG Cheng
ZHONG Ying-yu
Abstract：Objective To evaluate the efficacy of prone ventilation combined with fiberoptic bronchoscopy and alveolar lavage in the treatment of severe pneumonia with acute respiratory failure.Methods A total of 200 patients with severe pneumonia and acute respiratory failure from January 2022 to July 2023 were randomly assigned to three groups:control group 1(67 patients)received conventional supine ventilation;control group 2(66 patients)received supine ven-tilation with fiberoptic bronchoscopy and alveolar lavage;and the study group(67 patients)underwent prone ventilation combined with fiberoptic bronchoscopy and alveolar lavage.Changes in clinical pulmonary infection score(CPIS),arterial blood gas parameters,and serum inflammatory factors were observed.Treatment efficacy,ICU stay duration,total hospi-talization time,and 28-day mortality were compared among the groups.Results Post-treatment APACHE Ⅱ and CPIS scores significantly decreased in all groups compared to admission(P＜0.05),with the study group showing lower scores than the other two groups.The APACHE Ⅱ and CPIS scores in control group 2 were lower than those in control group 1(P＜0.05).Post-treatment,partial pressure of oxygen in arterial blood(PaO2),arterial oxygen saturation(SaO2),and PaO2/fraction of inspiration O2(FiO2)levels increased while partial pressure of carbon dioxide in arterial blood(PaCO2)levels decreased compared to admission(P＜0.05).The study group had higher PaO2,SaO2,and PaO2/FiO2 levels,and lower PaCO2 levels than the other groups(P＜0.05).Serum levels of C-reactive protein(CRP),interleukin-6(IL-6),white blood cell(WBC),and procalcitonin(PCT)decreased significantly in all groups,with the study group showing the lowest levels(P＜0.05).The total effective treatment rate in the study group was higher,and both ICU stay and total hospitalization duration were shorter than in the other groups,with a lower 28-day mortality rate(P＜0.05).Conclusion The combination of prone ventilation and fiberoptic bronchoscopy with alveo-lar lavage significantly alleviates the inflammatory response,improves blood gas parameters,enhances treatment efficacy,and reduces hospitalization time in patients with severe pneumonia and acute respiratory failure.
Keywords：fiberoptic bronchoscopypulmonary alveolar lavageprone position ventilationrespiratory failuresevere pneumonia
Publication Date：2024-11-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 1451-1456 )