Role of Toilet Bronchoscopy in RICU
COPD, Asthma, Cystic Fibrosis
About this trial
This is an interventional supportive care trial for COPD
Eligibility Criteria
Inclusion Criteria:
• Patients on mechanical ventilation with underlying dieases that are characterized with mucus overproduction such as asthma, chronic obstructive pulmonary disease (COPD), bronchiectasis, and cystic fibrosis.
- Patients on mechanical ventilation with visible large amount of sputum during suction in order to clear secretions.
- Patients on mechanical ventilation with radiologically diagnosed atelectasis and absent air-bronchograms
- Patient on NIV who was benefit from toilet bronchoscopy to clear retained secretion.
Exclusion Criteria:Absolute contraindications
- Absence of consent from the patient or his/her representative.
- Inability to adequately oxygenate the patient during the procedure.
- Current myocardial ischaemia.
- Significant haemodynamic instability.
- Life-threatening cardiac arrhythmias.
- Current significant bronchospasm.
- Undrained pneumothorax.
Relative contraindications
- Thrombocytopenia (platelet count ≤50,000 platelets/mm).
- INR of 2 or greater, or an elevated PTT.
- BUN >30.
- severe tracheal obstruction.
- Recent myocardial ischaemia and/or unstable angina.
- Intracranial hypertension.
- Poorly-controlled heart failure.
- Recent oral intake.
Sites / Locations
- Assuit university hospitalRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
group treated with toilet bronchoscope
group treated with standered care
Toilet bronchoscopy will be done as supportive care to sixty five (COPD,asthma,cystic bronchiectasis ) mechanically ventilated patients who fulfill the following criteria : Copious secretion Radiologically diagnosed atelectasis and absent air-bronchograms. Standard care of treatment will be carried out then assessment of a radiological, gasometric improvement and lung mechanics changes.
sixty five (COPD,asthma,cystic bronchiectasis ) mechanically ventilated patients who fulfill the following criteria : Copious secretion Radiologically diagnosed atelectasis and absent air-bronchograms. Standard care of treatment will be carried out then assessment of a radiological, gasometric improvement and lung mechanics changes.