Effects of bronchoscopic alveolar lavage–assisted mechanical ventilation on postoperative pulmonary infection and inflammatory factors in patients undergoing lung cancer surgery

Introduction: Patients undergoing lung cancer (LC) surgery often develop pulmonary infection (PI) due to poor sputum excretion ability leading to accumulation of secretions. Bronchoalveolar lavage (BAL) during fiberoptic bronchoscopy can be used to clear respiratory secretions and serve as a vehicle...

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Main Authors: Hui Zhu, Haiyang Lu
Format: Article
Language:English
Published: Termedia Publishing House 2024-07-01
Series:Videosurgery and Other Miniinvasive Techniques
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Online Access:https://www.mp.pl/videosurgery/issue/article/17887/
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author Hui Zhu
Haiyang Lu
author_facet Hui Zhu
Haiyang Lu
author_sort Hui Zhu
collection DOAJ
description Introduction: Patients undergoing lung cancer (LC) surgery often develop pulmonary infection (PI) due to poor sputum excretion ability leading to accumulation of secretions. Bronchoalveolar lavage (BAL) during fiberoptic bronchoscopy can be used to clear respiratory secretions and serve as a vehicle to locally deliver antibiotics that fight infection. Aim: This study explored the clinical efficacy of BAL-assisted mechanical ventilation (MV) in patients with postoperative PI and its influence on inflammatory parameters. Materials and methods: A total of 90 LC patients with postoperative PI were enrolled and divided into an MV group (n = 45) and a BAL-assisted MV group (n = 45). Therapeutic effects, respiratory mechanics, lung function parameters, blood gas indices, and levels of inflammatory parameters in peripheral blood were compared between the groups. Results: In comparison with the MV group, the PI control time, MV duration, temperature recovery time, and Clinical Pulmonary Infection Score of patients in the BAL-assisted MV group were greatly reduced. In both groups, airway resistance, peak airway pressure, and work of breathing decreased, while lung compliance increased. Maximum minute ventilation, total lung capacity, forced expiratory volume in 1 second, and maximum mid-expiratory flow were substantially enhanced following each treatment. In addition, post-treatment arterial oxygen pressure and saturation, pH value, and the ratio of partial pressure of oxygen in arterial blood to the fraction of inspiratory oxygen concentration increased, while partial pressure of carbon dioxide decreased in both groups. The levels of inflammatory markers (high-sensitivity C-reactive protein, procalcitonin, tumor necrosis factor α, high-mobility group box 1, interleukin 6, and macrophage inflammatory protein 1α) in peripheral blood were decreased regardless of the treatment method (all P <⁠0.05). All these findings were more pronounced in the BAL-assisted MV group. Clinical effective rate in the BAL-assisted MV group was higher than in the MV group (93.33% vs 77.78%; P <⁠0.05). Conclusions: BAL-assisted MV can achieve better results in treating postoperative PI than MV alone, effectively improving respiratory function and reducing systemic inflammatory response.
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spelling doaj-art-4255df771ad44710a0e6686be158b5d22025-01-29T17:28:51ZengTermedia Publishing HouseVideosurgery and Other Miniinvasive Techniques1895-45882299-00542024-07-0119334735510.20452/wiitm.2024.17887Effects of bronchoscopic alveolar lavage–assisted mechanical ventilation on postoperative pulmonary infection and inflammatory factors in patients undergoing lung cancer surgeryHui Zhu0Haiyang Lu1Department of Respiratory Endoscopy Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, ChinaDepartment of Respiratory Endoscopy Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, ChinaIntroduction: Patients undergoing lung cancer (LC) surgery often develop pulmonary infection (PI) due to poor sputum excretion ability leading to accumulation of secretions. Bronchoalveolar lavage (BAL) during fiberoptic bronchoscopy can be used to clear respiratory secretions and serve as a vehicle to locally deliver antibiotics that fight infection. Aim: This study explored the clinical efficacy of BAL-assisted mechanical ventilation (MV) in patients with postoperative PI and its influence on inflammatory parameters. Materials and methods: A total of 90 LC patients with postoperative PI were enrolled and divided into an MV group (n = 45) and a BAL-assisted MV group (n = 45). Therapeutic effects, respiratory mechanics, lung function parameters, blood gas indices, and levels of inflammatory parameters in peripheral blood were compared between the groups. Results: In comparison with the MV group, the PI control time, MV duration, temperature recovery time, and Clinical Pulmonary Infection Score of patients in the BAL-assisted MV group were greatly reduced. In both groups, airway resistance, peak airway pressure, and work of breathing decreased, while lung compliance increased. Maximum minute ventilation, total lung capacity, forced expiratory volume in 1 second, and maximum mid-expiratory flow were substantially enhanced following each treatment. In addition, post-treatment arterial oxygen pressure and saturation, pH value, and the ratio of partial pressure of oxygen in arterial blood to the fraction of inspiratory oxygen concentration increased, while partial pressure of carbon dioxide decreased in both groups. The levels of inflammatory markers (high-sensitivity C-reactive protein, procalcitonin, tumor necrosis factor α, high-mobility group box 1, interleukin 6, and macrophage inflammatory protein 1α) in peripheral blood were decreased regardless of the treatment method (all P <⁠0.05). All these findings were more pronounced in the BAL-assisted MV group. Clinical effective rate in the BAL-assisted MV group was higher than in the MV group (93.33% vs 77.78%; P <⁠0.05). Conclusions: BAL-assisted MV can achieve better results in treating postoperative PI than MV alone, effectively improving respiratory function and reducing systemic inflammatory response.https://www.mp.pl/videosurgery/issue/article/17887/bronchoscopic alveolar lavagemechanical ventilationlung cancerpulmonary infection
spellingShingle Hui Zhu
Haiyang Lu
Effects of bronchoscopic alveolar lavage–assisted mechanical ventilation on postoperative pulmonary infection and inflammatory factors in patients undergoing lung cancer surgery
Videosurgery and Other Miniinvasive Techniques
bronchoscopic alveolar lavage
mechanical ventilation
lung cancer
pulmonary infection
title Effects of bronchoscopic alveolar lavage–assisted mechanical ventilation on postoperative pulmonary infection and inflammatory factors in patients undergoing lung cancer surgery
title_full Effects of bronchoscopic alveolar lavage–assisted mechanical ventilation on postoperative pulmonary infection and inflammatory factors in patients undergoing lung cancer surgery
title_fullStr Effects of bronchoscopic alveolar lavage–assisted mechanical ventilation on postoperative pulmonary infection and inflammatory factors in patients undergoing lung cancer surgery
title_full_unstemmed Effects of bronchoscopic alveolar lavage–assisted mechanical ventilation on postoperative pulmonary infection and inflammatory factors in patients undergoing lung cancer surgery
title_short Effects of bronchoscopic alveolar lavage–assisted mechanical ventilation on postoperative pulmonary infection and inflammatory factors in patients undergoing lung cancer surgery
title_sort effects of bronchoscopic alveolar lavage assisted mechanical ventilation on postoperative pulmonary infection and inflammatory factors in patients undergoing lung cancer surgery
topic bronchoscopic alveolar lavage
mechanical ventilation
lung cancer
pulmonary infection
url https://www.mp.pl/videosurgery/issue/article/17887/
work_keys_str_mv AT huizhu effectsofbronchoscopicalveolarlavageassistedmechanicalventilationonpostoperativepulmonaryinfectionandinflammatoryfactorsinpatientsundergoinglungcancersurgery
AT haiyanglu effectsofbronchoscopicalveolarlavageassistedmechanicalventilationonpostoperativepulmonaryinfectionandinflammatoryfactorsinpatientsundergoinglungcancersurgery