Gravity-Dependent Blind Nasotracheobronchial Suction for Total Lung Collapse: A Report of Two Cases

TL;DR

This paper describes a non-invasive suctioning technique successfully used to treat lung collapse caused by mucus in two patients who couldn't undergo bronchoscopy.

Contribution

The study introduces gravity-dependent blind nasotracheobronchial suction as a novel, non-invasive alternative to bronchoscopy for managing mucus-induced lung collapse.

Findings

Two patients with total lung collapse due to mucus plugging were successfully treated with bedside suctioning.

The technique avoided the need for invasive bronchoscopy and resulted in clinical and radiographic improvement.

This approach is suitable for patients who cannot tolerate sedation or invasive procedures.

Abstract

Mucus plugging can lead to significant respiratory complications, especially in elderly or debilitated patients with impaired cough reflexes. Total lung collapse may occur when a main bronchus is occluded, often requiring bronchoscopy for diagnosis and treatment. However, bronchoscopy may not be feasible or an option in patients with comfort care measures or do-not-intubate status. We present the cases of two patients with total lung collapse due to mucus plugging who were successfully managed with bedside blind nasotracheobronchial suctioning with marked clinical and radiographic improvement, thus avoiding the need for more invasive bronchoscopy procedures. These cases highlight a practical and effective bedside alternative for managing lung collapse due to airway mucus obstruction in patients who are less likely to tolerate invasive interventions requiring sedation and bronchoscopy.

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