Application Of Bronchofiberoscopic Nasotracheal Intubation Plus Lung Lavage In Emergency Treatment Of Acute Respiratory Failure

ObjectivesTo explore the clinical efficacies of fiber bronchoscope-guided nasotracheal intubation plus lung lavage in the treatment of acute respiratory failue(ARF).Provide the basis for the wide use of the fiber bronchoscope technology in emergency rescue.MethodsA total of 180 patients fulfiled the standard diagnostic criteria of ARF were divided into treatment and control group(n=90 each).The treatment group underwent fiberoptic bronchoscope-guided nasotracheal intubation and lung lavage.And the control group had laryngoscopic orotracheal intubation.And the clinical efficacies were compared for two groups.Observing those index of two groups contained intubation time, intubation success rate for the first time, mechanical ventilation time, hospitaltalization time, unplanned extubation rate,the rescue success rate,probability of adverse events and so on.Results1.The comparison of intubation time,mechanical ventilation time, hospitaltalization time between the nasal intubation group and laryngoscopic orotracheal intubation groupThe result shows that the intubation time was(2.2±1.2) min in the treatment group and(3.1±2.3) min in the control group. The time was shorter in the treatment group than that in the control group.There were statistically significant differences between the two groups(P<0.05).The mechanical ventilation time was(105.38±45.89)h in the treatment group and(197.32±89.13)h in the control group.The time was shorter in the treatment group than that in the control group(P<0.05).The hospitaltalization time of treatment group was(9.68±2.89)d and the time of control group was(15.88±2.12)d.The hospitaltalization time of the treatment group was shorter than zhat of the control group(P<0.05).2.The comparison of intubation success rate for the first time,unplanned extubation rate,the rescue success rate between the nasal intubation group and laryngoscopic orotracheal intubation group.The result shows that the intubation success rate for the first time of treatment group was 100%, and the control group was 82.22%.The treatment group was significantly higher than the control group in the intubation success rate for the first time(P<0.05).The unplanned extubation rate of treatment group was 0%, and the control group was 12.22%.The treatment group was significantly shorter than the control group(P<0.05).The rescue success rate of treatment group was 94.44%, and the control group was 85.56%.The treatment group was significantly higher than that of the control group(P<0.05).3.The comparison of the positive rate of sputum culture between the common aspiration group and alveolar lavage group.The result shows that the sputum culture positive rate of alveolar lavage group was 65.56%,and the positive rate of sputum culture in alveolar lavage group was higher than that of the common aspiration group(31.11%).(P<0.05).Conclusion:1.Intubation through the nose and trachea under the guidance of the fiber support is more rapid,safer and efficient for some ARF patients;2.Tracheal intubation combined with bronchoalveolar lavage sputum culture positive rate is high, for the patients with acute respiratory failure sputum viscosity and apparent, it is worth clinical promotion.