Bronchoscopic Airway Clearance for Improving Lung Aeration in Mechanically Ventilated Patients With Atelectasis

NCT07594379 | Not Yet Recruiting

• 1 other identifier: BRONCO-CLEAR Trial
• Study Type: interventional
• Target: 104
• Locations: 0 countries
• Sites: N/A

Brief Summary

The goal of this clinical trial is to learn whether bedside flexible bronchoscopy-guided airway clearance can improve lung aeration in adult patients who are receiving invasive mechanical ventilation and have atelectasis with a high airway secretion burden. The main questions it aims to answer are: Does bedside flexible bronchoscopy-guided airway clearance reduce the proportion of nonaerated lung tissue from baseline to day 5? Does this treatment improve other lung aeration measures, respiratory mechanics, arterial blood gas parameters, pulmonary infection score, ventilator-free days, intensive care unit length of stay, and safety outcomes? Researchers will compare usual airway care plus bedside flexible bronchoscopy-guided airway clearance with usual airway care alone to see if bronchoscopy-guided airway clearance improves lung aeration and clinical outcomes. Participants will be randomly assigned to one of two groups. Participants in the usual care group will receive standard airway management, which may include airway suctioning, postural drainage, humidification, chest physiotherapy, and other routine respiratory care. Participants in the bronchoscopy group will receive the same usual care, plus bedside flexible bronchoscopy-guided airway clearance when predefined criteria for high airway secretion burden are met. Participants will have clinical assessments during the study, including chest imaging, respiratory mechanics measurements, arterial blood gas tests, pulmonary infection score assessment, and safety monitoring. The main assessment will compare quantitative chest computed tomography findings at baseline and day 5 to evaluate changes in nonaerated lung tissue.

Conditions

Atelectasis; Mechanical Ventilation

Keywords

Atelectasis; Mechanical Ventilation; Airway Secretion Retention

Outcome Measures

Primary Outcomes (1)

• Percentage Change in Nonaerated Lung Tissue From Baseline to Day 5

  Baseline to Day 5

Secondary Outcomes (3)

• Percentage Change in Normally Aerated Lung Tissue From Baseline to Day 5

  Baseline to Day 5, with chest CT performed within 24 hours of each time point

• Change in Respiratory Mechanics From Baseline to Day 5

  Baseline to Day 5

• Change in Arterial Blood Gas Parameters From Baseline to Day 5

  Change in Arterial Blood Gas Parameters From Baseline to Day 5

Study Arms (2)

Usual Airway Care

ACTIVE COMPARATOR

Other: Usual Airway Care

Bronchoscopy-Guided Airway Clearance

EXPERIMENTAL

Procedure: Flexible Bronchoscopy-Guided Airway Clearance

Interventions

Flexible Bronchoscopy-Guided Airway Clearance PROCEDURE

Bedside flexible bronchoscopy-guided airway clearance will be performed through the artificial airway in mechanically ventilated participants. The procedure will be used to inspect the tracheobronchial tree and remove retained airway secretions or mucus plugs by targeted suctioning. Small-volume saline lavage may be used when secretions are thick or difficult to remove. The intervention will be performed in addition to usual airway care when predefined criteria for high airway secretion burden are met. After the procedure, ventilator settings will be restored according to the study protocol and the participant's clinical condition.

Bronchoscopy-Guided Airway Clearance

Usual Airway Care OTHER

Usual airway care may include airway suctioning, postural drainage, chest physiotherapy, mechanical airway clearance techniques, humidification and heating of inhaled gas, cuff pressure monitoring, and timely clearance of airway secretions according to routine clinical practice.

Usual Airway Care

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Age 18 years or older
• Receiving invasive mechanical ventilation for at least 48 hours
• Presence of atelectasis confirmed by chest computed tomography, chest X-ray, or lung ultrasound
• High airway secretion burden, defined as requiring airway suctioning at least twice per hour during the previous 8 hours
• Written informed consent obtained from the participant or legally authorized representative

You may not qualify if:

• Expected duration of artificial airway maintenance less than 5 days
• Untreated tension pneumothorax Known or suspected aspiration
• Active intrapulmonary hemorrhage
• Severe dysfunction of other organs with expected short-term mortality within 7 days or need for palliative care
• Any other condition judged by the medical team to make the participant unsuitable for the study
• Informed consent not obtained

Sponsors & Collaborators

• Southeast University, China: lead

MeSH Terms

Conditions

Pulmonary Atelectasis

Condition Hierarchy (Ancestors)

Lung Diseases; Respiratory Tract Diseases

Study Officials

• Ling Liu, PHD

  Zhongda Hospital, School of Medicine, Southeast University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Mengyuan Shen, MD

CONTACT

+8615996997839; Smy0116tu@163.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: professor

Study Record Dates

• First Submitted: May 12, 2026
• First Posted: May 18, 2026
• Study Start (Estimated): June 1, 2026
• Primary Completion (Estimated): December 31, 2027
• Study Completion (Estimated): June 1, 2028
• Last Updated: May 18, 2026

Record last verified: 2026-05