Effect of invasive-noninvasive sequential ventilation combined with bronchoscopic alveolar lavage on efficacy and diaphragmatic function in patients with chronic obstructive pulmonary disease complicated with respira-tory failure
Liu Shijie
Liu Xiaoli
Ye Ning
Kong Yan
Zhou Meijing
Abstract：Objective To investigate the therapeutic effect of invasive-noninvasive sequential ventilation combined with bronchoscopic alveolar lavage on chronic obstructive pulmonary disease(COPD)complicated with respiratory failure.Methods A total of 58 patients with COPD complicated with respiratory failure admitted to the Department of Emergency and Department of Respiratory,the First Affiliated Hospital of Guilin Medical University from July 2021 to June 2023 were enrolled.The patients were divided into the control group and the observation group using the random number table method,with 29 cases in each group.The control group was treated with invasive-noninvasive sequential ventilation alone,while the observation group was treated with bronchoscopic alveolar lavage on the basis of the control group's regimen.Oxidative stress indexes,immune function indexes,pulmonary function indexes,diaphragmatic status,clinical efficacy and adverse reactions were compared between the two groups.Results After treatment,the levels of superoxide dismutase and glutathione in both groups were signifi-cantly higher than those before treatment,and the levels in the observation group were significantly higher than those in the control group;the malondialdehyde levels in both groups were significantly lower than those before treatment,and the level in the observation group was significantly lower than that in the control group(all P＜0.05).The levels of CD3+,CD4+,and the CD4+/CD8+ratio in both groups were higher than those before treatment,and the indexes in the observation group were significantly higher than those in the control group;the CD8+levels in both groups were lower than those before treatment,and the level in the observation group was significantly lower than that in the control group(all P＜0.05).The forced vital capacity(FVC),forced expiratory volume in the first second(FEV1),FEV1/FVC ratio,diaphragm thickening fraction and diaphragm excursion in both groups were signifi-cantly higher than those before treatment,and the indexes in the observation group were significantly higher than those in the control group(all P＜0.05).The total effective rate of the observation group was significantly higher than that of the control group[86.2％(25/29)vs 62.1％(18/29)](P＜0.05).The time to respiratory failure correction,mechanical ventilation time and length of hospital stay in the observation group were significantly shorter than those in the control group(all P＜0.05).During treatment,there was no significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion Invasive-noninvasive sequential ventilation combined with bronchoscopic alveolar lavage can significantly improve the therapeutic effect in patients with COPD complicated with respiratory failure,ameliorate oxidative stress and immune indexes,promote the recovery of diaphragmatic function,with high safety.
Keywords：Chronic obstructive pulmonary diseaseRespiratory failureBronchoscopic alveolar lavageInvasive-noninvasive sequential ventilation
Publication Date：2026-03-18
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：5( 340-344 )