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HomeAnswersPulmonology (Asthma Doctors)bronchoscopyCan bronchoscopy help in lung collapse caused due to pneumonia?

Will bronchoscopy help to treat my uncle's collapsed lungs?

The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

iCliniq medical review team

Published At June 6, 2017
Reviewed AtJuly 4, 2023

Patient's Query

Hi doctor,

My uncle has been admitted to a hospital, after a week of high-grade fever along with a cough, which gradually increased. They took a chest x-ray and blood tests and confirmed that it is pneumonia, and my uncle was on oxygen (O2). He was also suspected for swine flu, and we waited for the reports, but gradually his lungs functioning started diminishing. He showed pO2 levels of 60 in arterial blood gas (ABG) at this time. But the computed tomography (CT) scan of the lungs depicted bilateral infection. But, the doctor treating him took it reluctantly and was waiting for the swine flu report. H1N1 was negative, yet his breathing became a major problem. All this happened in two days, on the night of the second day, he was almost closing his eyes with a fever of 101 F and partial pressure of O2 (pO2) levels of 54 in ABG. He was shifted to intensive care unit (ICU) and was put on non invasive ventilation (NIV). The next morning he did not improve, and his pO2 levels were 45. So, we shifted him to a better hospital, who again put him in an isolated ward, suspecting H1N1, but diagnosed it typical pneumonitis. All other parameters of his were normal, but he was put on a ventilator. Here also H1N1 report was negative, but the pulmonologist said that the pictures depict swine flu. The team said that he his struggling in the ventilator too, but since all other vitals are stable they promised us that he would recover slowly. On the ventilator, he showed pO2 levels of 90, but the respiratory element in the monitor showed 25 to 35. He was on the ventilator for seven days, in between they tried weaning, but he could not tolerate. On the eighth day, he was extubated and put on NIV fearing for ventilator associated pneumonia (VAP), he sustained for 24 hours in NIV with great difficulty with diminishing pO2 levels, and the respiratory element in monitor rose to 40. During this 24 hours, he was extremely drowsy, and he did not respond to us. He was restless and breathed with so much of difficulty, but then neurologist concluded that he is psychologically dull. After this tracheostomy was done and he was intubated again. Now it is the third day he is on the stoma. But yet he is in full artificial support now and not breathing naturally. A CT scan was taken yesterday, and I am attaching it. Again the doctors are suspecting swine flu, although the reports are negative. He is on high antibiotics, so the infection did not spread. But the lungs are full of scars, but he does not have a fever. We do not know where to go, please help. He has not been on natural nutrition for nearly three weeks, so he is very tired. His muscles need to be mobilized, and so they thought of keeping him on the chair, but he could not. And today again he is on ventilation. Today the pulmonologist told us that they are going to do an endoscopy to remove some mucus. What is his condition? I am attaching all the reports that are available to me. Can I know if the CT reports taken two weeks back and now show any improvement? Will the endoscopy procedure help? Is there any other better treatment for the same? Will this infection of viral pneumonia decrease? The doctors tell us that he is psychologically dull and so he hesitates to fight with breathing. What other things need to be done to make his atmosphere good?

Hi,

Welcome to icliniq.com. I have seen all the reports (attachment removed to protect patient identity) This history seems to be of acute viral pneumonitis, probably due to a new unknown strain or H1N1. Sometimes, cultures may be negative while he can still harbor it. The computed tomography (CT) scan is suggestive of ARDS (acute respiratory distress syndrome). When the respiratory system fails, it becomes very difficult to wean the patient out of the ventilator. Pulmonary rehabilitation can be sought once he is out of the ventilator. They might be doing a bronchoscopy and not an endoscopy. Yes, it will help in removing mucus plug and reinflating the collapsed lung. The treatment is with higher antibiotics and antiviral like Tamiflu (Oseltamivir phosphate). Sudden viral infections are very bad for few people, nothing much can be done except for respiratory support.

Patient's Query

Thank you doctor,

Today they did the procedure to remove mucus, but the doctor told that they did not remove as much as expected. They removed only a little fluid. Will he gradually start breathing on his own? Can I know whether these type of infections decrease? Thank you for your patience, I am attaching the other reports.

Hi,

Welcome back to icliniq.com. I have seen all the reports (attachment removed to protect patient identity). Yes,the reports show slight improvement. I hope he gets better, only time will tell. The infection has decreased, but the damage it has done to the lungs is too much, that is why he is needing artificial support.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Anshuman Srivastava
Dr. Anshuman Srivastava

Internal Medicine

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