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.
 
 
 
Highlights
Ventilator-associated pneumonia (VAP), usually caused by mechanical ventilation and with a high morbidity in the elderly population, leads to weaning failure, and strikingly increases the mortality of the patients, which inflicts damage on patients’ quality of life [1,2,3]
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 recent two years were selected and randomized to group A and group B
As one of the serious complications caused by mechanical ventilation, VAP is extremely unfavorable to the prognosis of patients with a mortality up to 60%, which requires effective treatment measures to ensure the safety of patients [16,17,18,19]
Summary
Ventilator-associated pneumonia (VAP), usually caused by mechanical ventilation and with a high morbidity in the elderly population, leads to weaning failure, and strikingly increases the mortality of the patients, which inflicts damage on patients’ quality of life [1,2,3]. The primary purpose of VAP treatment in clinical practice is to bring down the infection
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