Bronchial toilet

As bronchial - ger .: respiratory toilet - the measures are referred to the Keeping the airway used in patients with impaired self-cleaning mechanisms. These are mostly intubated or tracheotomized but also unconscious and generally weakened patients. This should prevent aspiration pneumonia and atelectasis formation.

Since this is an important, but also very uncomfortable care measure for the patient, this should only be carried out if there is actually secretion in the trachea or the main bronchi. It is suctioned "blind" using a tracheal or bronchial catheter or selectively ("under sight") using a bronchoscope under sterile conditions after the patient has been informed accordingly.

Since the procedure relating to the bronchial toilet is one of the exogenous risk factors for ventilator-associated pneumonia, the appropriate training of the nursing staff plays a decisive role. A rinsing of the bronchial tree that takes place (with isotonic saline solution for better removal of the often viscous secretion) is called bronchial lavage .

Factors that hinder adequate bronchial toilet are:

previous operations in the head and neck area (and inadequate pain therapy)
Immobilization z. B. with a present multiple trauma

In a broader sense, the correct "coughing up" of the morning, insufficiently liquefied or mobilized bronchial secretions in patients with chronic bronchitis or other chronic diseases of the respiratory tract is referred to as a bronchial toilet. First, you take a deep breath and then slightly clear your throat with the first half of the exhaled volume. Only with the second half of the remaining tidal volume should the patient cough repeatedly.

Individual evidence

↑ Claudia Leoni-Scheiber: Relationship between the quantity and quality of the bronchial toilet and the incidence of nosocomial pneumonia in endotracheally intubated patients. In: intense. 14, 2006, pp. 214-221, doi : 10.1055 / s-2006-926994 .
↑ Hilmar Burchardi: Etiology and pathophysiology of acute respiratory failure (ARI). In: J. Kilian, H. Benzer, FW Ahnefeld (ed.): Basic principles of ventilation. Springer, Berlin a. a. 1991, ISBN 3-540-53078-9 , 2nd, unchanged edition, ibid. 1994, ISBN 3-540-57904-4 , pp. 47-91; here: p. 89 ( Difficult bronchial toilet ).

Web links

[1] Claudia Leoni-Scheiber: Relationship between the quantity and quality of the bronchial toilet and the incidence of nosocomial pneumonia in endotracheally intubated patients. In: intense. 14, 2006, pp. 214-221, doi : 10.1055 / s-2006-926994 .

[2] Hilmar Burchardi: Etiology and pathophysiology of acute respiratory failure (ARI). In: J. Kilian, H. Benzer, FW Ahnefeld (ed.): Basic principles of ventilation. Springer, Berlin a. a. 1991, ISBN 3-540-53078-9 , 2nd, unchanged edition, ibid. 1994, ISBN 3-540-57904-4 , pp. 47-91; here: p. 89 ( Difficult bronchial toilet ).