• Zhihao Qiao, Jianghong Yu, Kai Yu, and Mengya Zhang.
• Department of Critical Care Medicine, Guangdong Tongjiang Hospital, Foshan, Guangdong Department of Critical Care Medicine, The First Hospital of Quanzhou, Quanzhou, Fujian, China.
• Medicine (Baltimore). 2018 Aug 1; 97 (31): e11631e11631.

BackgroundTo 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).MethodsPatients 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.ResultsThere 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).ConclusionBronchoscopic sputum suction combined with sequential invasive-noninvasive mechanical ventilation at PIC window showed clinical effects in treating respiratory failure patients with AECOPD.

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