Imaging-guided bronchoscopy significantly improves lung function, reduces inflammation in acute bronchiectasis exacerbations

Patients suffering from acute bronchiectasis exacerbations frequently experience severe pulmonary inflammation, impaired lung function, and a diminished quality of life. Current standard-of-care, primarily anti-infective and symptomatic treatment, often struggles to adequately clear airway secretions and resolve inflammation, leading to prolonged recovery and recurrent exacerbations. This gap highlights the need for more targeted and effective interventions that can directly address the underlying pathology and improve patient outcomes. Bronchoscopy, when guided by imaging, offers a potential avenue for precise intervention.

This randomized controlled trial enrolled 80 inpatients with acute bronchiectasis exacerbations, allocating them equally into two groups (n=40 each). The control group received conventional anti-infective and symptomatic treatment. The intervention group received additional imaging-assisted bronchoscopic interventions. Researchers assessed pulmonary function (forced expiratory volume in the first second [FEV1], forced vital capacity [FVC], FEV1/FVC), inflammatory markers (C-reactive protein [CRP], procalcitonin [PCT], white blood cell count [WBC]), and St George's Respiratory Questionnaire (SGRQ) quality of life scores at baseline, and then at 1, 2, and 4 weeks post-intervention. Adverse events and overall effectiveness were also recorded.

Baseline characteristics, pulmonary function, inflammatory markers, and SGRQ scores showed no significant intergroup differences (p > 0.05). However, at 1, 2, and 4 weeks post-intervention, the imaging-assisted bronchoscopy group demonstrated significantly greater improvements across multiple key metrics. They exhibited higher FEV1 values, along with notably lower CRP and PCT levels, and reduced SGRQ scores compared to the control group (all p < 0.05). The generalized estimation equation (GEE) model further confirmed that the magnitude of improvement in the intervention group progressively increased over time (p < 0.001).