Gravity-Dependent Blind Nasotracheobronchial Suction for Total Lung Collapse: A Report of Two Cases

Mucus plugging can lead to significant respiratory complications, especially in elderly or debilitated patients with impaired cough reflexes. Total lung collapse may occur when a main bronchus is occluded, often requiring bronchoscopy for diagnosis and treatment. However, bronchoscopy may not be feasible or an option in patients with comfort care measures or do-not-intubate status. We present the cases of two patients with total lung collapse due to mucus plugging who were successfully managed with bedside blind nasotracheobronchial suctioning with marked clinical and radiographic improvement, thus avoiding the need for more invasive bronchoscopy procedures. These cases highlight a practical and effective bedside alternative for managing lung collapse due to airway mucus obstruction in patients who are less likely to tolerate invasive interventions requiring sedation and bronchoscopy.