Airway Clearance and Bronchoalveolar Lavage for Bronchiectasis Patients With Exacerbation

Study Overview
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Brief Summary
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No study have evaluated the efficacy and safety of airway clearance therapy (ACT) and bronchoalveolar lavage (BAL) under bronchoscope for bronchiectasis. This study aimed to evaluate the clinical efficacy and safety of tran-bronchoscopy airway clearance and bronchoalveolar lavage in the treatment of moderate to severe bronchiectasis with acute exacerbation:A randomized, prospective cohort study.

Detailed Description
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The aim of this study was to evaluate the efficacy and safety of ACT combined with BAL for bronchiectasis patients with acute exacerbation through the whole study process, which will provide a high quality of evidence-based strategies for the treatment, revision and optimization of international and domestic clinical guidelines for bronchiectasis. All the participants will be required to check the various efficacy and safety indicators.

Official Title
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Clinical Efficacy and Safety of Tran-bronchoscopy Airway Clearance and Bronchoalveolar Lavage in the Treatment of Moderate to Severe Bronchiectasis With Acute Exacerbation

Conditions
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Bronchiectasis Adult

Intervention / Treatment
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* Device: Version BF-1T26 electronic bronchoscope


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Willing to join in and sign the informed consent form; The diagnosis of bronchiectasis need reference to the definition of European Respiratory Society guidelines for the management of adult bronchiectasis. published by the european respiratory journal in 2017, defined by the presence of both permanent bronchial dilatation on computed tomography (CT) scanning and the clinical syndrome of cough, sputum production and/or recurrent respiratory infections; Pulmonary exacerbation in patients with bronchiectasis was required to meet three or more of the following key symptoms for at least 48h: Cough; Sputum volume and/or consistency; Sputum purulence; Breathlessness and/or exercise tolerance; Fatigue and/or malaise; Haemoptysis, and a clinician determines that a change in bronchiectasis treatment is required; According to the researchers, the subjects were willing and able to follow the protocol and were able to tolerate bronchoscopy; Patients with good compliance: the subject must be willing to follow the test plan requirements in the research center to complete all the assessment of the visit. Exclusion Criteria: Pregnant or lactating women; Hypogammaglobulinemia or other autoimmune diseases; Clinical diagnosis of ABPA; Non tuberculosis mycobacteria positive 2 years before; Allergies or allergic to a variety of drugs; Poor compliance or can not cooperate judged by doctors; Participated in other clinical trials for nearly three months; The researchers considered that the subject had other circumstances that were unfit to attend; Suffering from a significant disease or condition outside of bronchiectasis, as judged by the researchers, may lead to subjects at risk due to participate in the study,or the disease that have an impact on the research result and the ability of subjects to participate in this study; Bronchoscopy contraindication; Patients with heart, liver and kidney, nervous system, endocrine and other systemic diseases, may not be able to adhere to the completion of the study, or will affect the research process; Patients who refused to sign informed consent after targeted explanation.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Therapy of bronchoalveolar lavage group<br>Patients with bronchiectasis exacerbations treat with fundamental treatment combining with the therapy of airway clearance and bronchoalveolar lavage. | Device: Version BF-1T26 electronic bronchoscope<br>* Interventions involving the therapy of airway clearance and bronchoalveolar lavage by Version BF-1T26 electronic bronchoscope<br>|
| Fundamental treatment group<br>In the control group,fundamental treatment was adopted according to the guidelines | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Time to the first acute exacerbation after treatment | The median time to first acute exacerbation after discharge.We used GraphPad Prism 6.0 Kaplan-Meier survival curve and the log-rank test to compare the differences of the primary outcome between both groups | 3 month | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The changes of mMRC score before and after treatment | Modified Medical Research Centre | 7 days | 
| The changes of CAT score before and after treatment | COPD Assessment Test | 7 days | 
| The changes of SGRQ before and after treatment | St. George respiratory questionnaire | 7 days | 
| The changes of LCQ before and after treatment | Leicester Cough Questionnaire | 7days | 
| The changes of 6MWD before and after treatment | 6 Minute Walking Distance | 1 days |