Impact of fiberoptic bronchoscopy with bronchoalveolar lavage on infection control in patients with severe ventilator-associated pneumonia

Abstract

Objectives  To evaluate the impact of Fiberoptic Bronchoscopy (FOB) with Bronchoalveolar Lavage (BAL) on infection control in patients with severe Ventilator-Associated Pneumonia (VAP) and compare it with conventional treatments to provide a reliable basis for clinical therapy.

Method  This retrospective study included 86 patients with severe VAP who were admitted to the hospital between November 2019 and June 2023. Based on the treatment regimen, the patients were divided into two groups: a control group (conventional lavage and suction therapy, n = 32) and an observation group (FOB with BAL, n = 54).

Results  The bacterial clearance rate of the observation group was significantly higher than in the control group (87.93 % vs. 70.27 %, p < 0.05). On days 5 and 7 post-treatment, the CPIS scores of the observation group were markedly lower than those of the control group (p < 0.05). After Post-treatment, the observation group demonstrated significantly superior respiratory mechanics (PIP, Cdyn, Raw), blood gas analysis parameters (PaO₂, PaO₂/FiO₂, PaCO₂), and pulmonary function indicators (PEF, PEEPi) compared to the control group (p < 0.05). The levels of inflammatory markers in the observation group were notably reduced (p < 0.05). Additionally, the duration of mechanical ventilation, infection control, and length of stay were significantly shorter in the observation group (p < 0.05). There was no significant difference in the incidence of complications between the two groups (p > 0.05).

Conclusions  FOB with BAL as adjunctive therapy for VAP demonstrated significant advantages in enhancing respiratory mechanics, pulmonary function, blood gas analysis, inflammatory response, and bacterial clearance rate while effectively reducing mechanical ventilation duration and length of stay.