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

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.