One hospital performed 67 lung lavages in one day! Do you need to perform lung lavages if you have mycoplasma pneumonia? Expert answers

Do you need a lung cleanse?

Mycoplasma pneumoniae pneumonia

Recent

Mycoplasma pneumonia in children has attracted wide attention

When is the child contagious?

Do you need infusion or lung lavage?

I am worried that there will be too many people in the hospital. Can I take medicine on my own?

Relevant medical experts give answers

7-year-old boy coughing for a week

Inflammatory lesions in the lungs

According to Da Wan News, recently a 7-year-old boy Qiangqiang (pseudonym) had fever and cough for 6 days, with his body temperature fluctuating around 40℃. After being hospitalized in a local hospital, his condition did not show significant improvement.

"The child's cough is getting worse and worse, and his spirit is getting worse." Qiangqiang's mother was very anxious and transferred her child to Fudan Pediatrics Anhui Hospital (Anhui Provincial Children's Hospital). The chest CT examination results showed: extensive gas accumulation in the subcutaneous part of the neck and chest and in the mediastinal space; multiple inflammatory lesions in the left upper lobe and right lower lobe of the lung, and a small amount of pleural effusion on the left side.

After assessing the patient's condition, Wang Yan, the attending physician of the hospital's pediatric respiratory department, urgently performed a fiberoptic bronchoscopy examination and treatment on him. He found that the basal segments of his left upper lobe and right lower lobe were completely blocked by sputum plugs. He used lavage and forceps to remove the sputum plugs, and applied medication precisely to the pneumonia.

Source: Da Wan News

After treatment, Qiangqiang's temperature began to return to normal. Four days later, a chest CT scan revealed that the consolidation range had expanded. The doctor used a fiberoptic bronchoscope to clear the sputum plug in the trachea. Currently, the child's temperature has returned to normal, and he occasionally coughs. His symptoms have improved significantly compared to before.

According to Da Wan News, Qiangqiang's condition is not an isolated case. Due to the recent high incidence of Mycoplasma pneumoniae infection in children, some children have even developed obvious pulmonary complications such as pulmonary consolidation and atelectasis. The work pace of the pediatric endoscopy room of Fudan Children's Anhui Hospital (Anhui Provincial Children's Hospital) has also begun to increase.

"We used to perform only about 10 fiberoptic bronchoscopy examinations a day on average, but recently we have been doing more than 50 a day on average, with a peak of 67 in one day. This examination is what parents often call lung washing." Wang Yan introduced that because many severe Mycoplasma pneumoniae pneumonias cause sputum plugs, fiberoptic bronchoscopes must be used to wash out the sputum plugs to keep the respiratory tract open.

01 Do you need to wash your lungs if you have Mycoplasma pneumonia?

According to the Children's Hospital Affiliated to Fudan University, the full name of "lung washing" is bronchoalveolar lavage, which is a minimally invasive endoscopic technique performed through a bronchoscope. A bronchoscope is a soft mirror with a light source and a lens. During the operation, the soft mirror is inserted through the mouth or nose, from the trachea into the bronchi, which can help doctors directly observe the lesions of the trachea, bronchial mucosa, and lumen.

Source: Photo Network

Bronchoalveolar lavage is the process of injecting a specified amount of sterile saline into the bronchoalveoli through a bronchoscope, and then fully aspirating to obtain qualified alveolar lavage fluid for relevant testing, especially infectious pathogen testing. At the same time, it can also be used to flush the local pneumonia area and expel a large amount of inflammatory secretions (sputum) in the pneumonia area, thereby achieving the purpose of diagnosing and treating lung diseases.

Comparison of severe Mycoplasma pneumoniae pneumonia atelectasis before and after treatment. Source: Children's Hospital Affiliated to Fudan University

In response to parents' concerns about the "lung lavage" operation, Zhou Wei, deputy chief physician of the Department of Pediatrics at Peking University Third Hospital, said in an interview with Xinhua News Agency on November 12, "This year, many children with mycoplasma pneumonia have undergone lung lavage treatment. Lung lavage has strict operating indications. For example, if a child has atelectasis, local consolidation, or even very serious inflammatory reactions such as necrosis and sputum embolism, lung lavage may be required under bronchoscope to clear the airway. At the same time, the extent of lung lesions can also be seen under the microscope."

02 Is Mycoplasma pneumonia best treated with intravenous infusion?

Zhou Wei said that some parents believe that intravenous infusion is better than oral treatment, but there is actually no such conclusion. The treatment method should be selected according to the child's condition. Children with severe pneumonia can choose intravenous infusion, while most children have mild symptoms and can be treated with oral medication.

"After being infected with Mycoplasma pneumoniae, there is a latent period of several days before the fever begins, during which the patient is contagious to a certain extent." Zhou Wei said that wearing a mask can prevent infection to a certain extent, but it is not realistic for children to wear masks strictly and in accordance with regulations all the time. Avoiding crowded and enclosed public places, ventilating the house frequently, cleaning and disinfecting schools regularly, and increasing outdoor activities are all helpful in preventing infection.

Wear a mask

Maintain hygiene

Vaccination

Self-monitoring

03 It is recommended that the elderly and children receive pneumonia vaccination

In addition to mycoplasma, bacteria and viruses can also cause pneumonia. Ye Huan, director of the respiratory department of Beijing Chest Hospital, pointed out that pneumonia patients often have typical symptoms such as fever, cough, and difficulty breathing. Young children and the elderly should pay special attention to prevention. It is recommended that the elderly and children over 65 years old be vaccinated against pneumonia. Although there is currently no vaccine for Mycoplasma pneumoniae, the pneumonia vaccine can prevent a variety of pneumococci.

Source: Photo Network

Experts pointed out that the choice of medication is different for pneumonia caused by different pathogens. For example, for mycoplasma pneumonia, penicillin and cephalosporin antibiotics are ineffective, and the most commonly used antibiotics are macrolide antibiotics. Patients suspected of pneumonia should go to the hospital for medical treatment in time, and receive targeted treatment after diagnosis, avoiding blind medication such as "taking antibiotics on their own".

Source: Xinhua News Agency, Dawan News, Children's Hospital Affiliated to Fudan University, Beijing Daily

Editor: Zheng Ke

Proofread by Li Jiahua

Second trial丨Pan Ling Zhang Yue

Final Review丨Liu Huiying Zhang Ruxian