Tropical Journal of Pharmaceutical Research

Original Research Article | OPEN ACCESS

Effect of acetylcysteine solution combined with fiberoptic bronchoscopy alveolar lavage in elderly patients with severe ventilator-associated pneumonia

Ju Guo¹, Ping Wang², Xiaoyu Ma²

¹The First Affiliated Hospital of Xinjiang Medical University, Department of Critical Care Medicine,137 Liyushan South Road, Urumqi, Xinjiang 830054; ²The Fourth Hospital of Shijiazhuang, Department of Anesthesiology. 206 Zhongshan East Road, Shijiazhuang 050000, China.

For correspondence:- Xiaoyu Ma Email: ganyuetan1857@163.com

Accepted: 28 April 2021 Published: 31 May 2021

Citation: Guo J, Wang P, Ma X. Effect of acetylcysteine solution combined with fiberoptic bronchoscopy alveolar lavage in elderly patients with severe ventilator-associated pneumonia. Trop J Pharm Res 2021; 20(5):1061-1066 doi: 10.4314/tjpr.v20i5.25

© 2021 The authors.
This is an Open Access article that uses a funding model which does not charge readers or their institutions for access and distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0) and the Budapest Open Access Initiative (http://www.budapestopenaccessinitiative.org/read), which permit unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited..

Abstract

Purpose: To explore the effect of acetylcysteine solution combined with fiberoptic bronchoscopy alveolar lavage in elderly patients with severe ventilator-associated pneumonia (VAP).

Methods: A total of 120 elderly patients with severe VAP admitted to Department of Critical Care Medicine, the First Affiliated Hospital of Xinjiang Medical University in the past two years were selected for this study. They were randomized into groups A and B. Group B underwent fiberoptic bronchoscopy alveolar lavage for 7 days, group A received acetylcysteine solution plus. Clinical pulmonary infection score (CPIS), respiratory mechanics changes, blood gas levels, inflammatory factor levels, antibiotic use time and mechanical ventilation time were compared.

Results: Compared to group B, group A witnessed a lower CPIS, an evidently superior dynamic lung compliance (Cdyn), and worse for other respiratory mechanics indices (p < 0.001). After treatment, the partial pressure of blood oxygen (PaO₂) and oxygenation index (PaO₂/FiO₂) saw a surge; the partial pressure of carbon dioxide (PaCO₂) tapered off, and the levels of inflammatory factors witnessed a slump in group A than compared with those for group B (p < 0.001). A shorter antibiotic use time and mechanical ventilation time was observed in group A compared with group B (p < 0.001).

Conclusion: Acetylcysteine solution combined with fiberoptic bronchoscopy alveolar lavage yields a promising outcome in notably ameliorating CPIS, respiratory mechanics indicators and blood gas levels, driving down the level of inflammatory factors and diminishing treatment time in elderly patients with severe VAP.

Keywords: Acetylcysteine, Fibrobronchoscope, Alveolar lavage, Pneumonia