ACUTE LOBAR ATELECTASIS - PROSPECTIVE COMPARISON OF FIBEROPTIC BRONCHOSCOPY AND RESPIRATORY THERAPY

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Abstract
The usefulness of fiberoptic bronchoscopy was evaluated for treatment of acute lobar atelectasis. Subjects (31) were randomly allocated to fiberoptic bronchoscopy followed by respiratory therapy for 48 h, or to respiratory therapy alone for the same period. No significant differences between groups regarding restoration of volume loss were detected after the 1st treatment intervention, at 24 or at 48 h (P > 0.20). The mean percentage resolution of volume loss immediately after bronchoscopy (38%) closely approximated that after the 1st respiratory therapy treatment in subjects who had not undergone bronchoscopy (37%). An air bronchogram was a predictor of delayed resolution for both groups. At 24 h, 26% of the initial volume loss was recovered in 11 subjects with air bronchograms, whereas 20 subjects without air bronchograms demonstrated 83% resolution (P < 0.001). Fiberoptic bronchoscopy apparently does not add to respiratory therapy in the treatment of acute lobar atelectasis and an air bronchogram predicts delayed resolution of collapse.