Study on the Efficacy of Acetylcysteine in Severe Pneumonia in Children under Electronic Bronchoscopy

Ji WANG; Songtao BIN; Li TAN

doi:10.12259/j.issn.2095-610X.S20240615

Volume 45 Issue 6

Jul. 2024

Turn off MathJax

Article Contents

Article Navigation > Journal of Kunming Medical University > 2024 > 45(6): 113-119

Ji WANG, Songtao BIN, Li TAN. Study on the Efficacy of Acetylcysteine in Severe Pneumonia in Children under Electronic Bronchoscopy[J]. Journal of Kunming Medical University, 2024, 45(6): 113-119. doi: 10.12259/j.issn.2095-610X.S20240615

Citation:

Ji WANG, Songtao BIN, Li TAN. Study on the Efficacy of Acetylcysteine in Severe Pneumonia in Children under Electronic Bronchoscopy[J]. Journal of Kunming Medical University, 2024, 45(6): 113-119. doi: 10.12259/j.issn.2095-610X.S20240615

Citation:

PDF( 620 KB)

Study on the Efficacy of Acetylcysteine in Severe Pneumonia in Children under Electronic Bronchoscopy

doi: 10.12259/j.issn.2095-610X.S20240615

Dept. of Respiratory Medicine，Kunming Children’s Hospital，Kunming Yunnan 650031，China

Received Date: 2024-02-21
Available Online: 2024-05-23
Publish Date: 2024-06-25

Abstract

Abstract

Objective To explore the clinical efficacy of acetylcysteine solution retained perfusion inhalation treatment under electronic bronchoscopy in children with severe bacterial pneumonia. Methods From January 1, 2021 to December 31, 2022, 86 children with severe bacterial pneumonia treated in the Department of Respiratory Medicine of Kunming Children’ s Hospital were randomly divided into a control group （n = 43） and a study group （n = 43）. The children in the control group received electronic bronchoscopy under physiological saline pulmonary alveolar lavage treatment. The study group received acetylcysteine solution treatment retained after the end of the pulmonary lavage treatment. The clinical treatment effects, inflammatory indicators, tidal breathing function, and adverse reactions of the two groups were compared. Results After treatment, compared with control group, the hospitalization time, cough disappearance time and comorbidities disappearance time of children in study group were significantly shortened （P < 0.05）, and the total effective rate of study group was significantly higher than that of control group （P < 0.05）. The levels of white blood cell count, procalcitonin, C-reactive protein, interleukin-6, and tumor necrosis factor-α of study group were significantly lower than those of control group （P < 0.05）. The tidal volume per kilogram of body weight, peak time ratio, and peak volume ratio levels of study group were significantly higher than those of control group （P < 0.05）.There was no statistically significant difference in the adverse drug reactions between two groups （P > 0.05）. Conclusion Under electronic bronchoscopy, preserving perfusion and inhaling acetylcysteine solution can significantly improve the clinical symptoms, inflammatory indicators, and lung function of children with severe bacterial pneumonia, and it is relatively safe.
- Children,
- Severe bacterial pneumonia,
- Bronchoalveolar lavage,
- Acetylcysteine solution,
- Inflammatory reaction

FullText(HTML)

References(28)

References

[1]	Rueda Z V,Aguilar Y,Maya M A,et al. Etiology and the challenge of diagnostic testing of community-acquired pneumonia in children and adolescents[J]. BMC Pediatr,2022,22(1):169-183. doi: 10.1186/s12887-022-03235-z
[2]	Zhou Y,Wang J,Chen W,et al. Impact of viral coinfection and macrolide-resistant mycoplasma infection in children with refractory mycoplasma pneumoniae pneumonia[J]. BMC Infect Dis,2020,20(1):633-643. doi: 10.1186/s12879-020-05356-1
[3]	Thea D M,Seidenberg P,Park D E,et al. Limited utility of polymerase chain reaction in induced sputum specimens for determining the causes of childhood pneumonia in resource-poor settings: findings from the Pneumonia Etiology Research for Child Health (PERCH) Study[J]. Clin Infect Dis,2017,64(suppl 3): S289-300.
[4]	Sandhaus S, Swick A G. Specialized proresolving mediators in infection and lung injury[J]. Biofactors,2021,47(1):6-18.
[5]	王龙, 王广军, 梁群. 重症肺炎发病机制及中西医治疗研究进展[J]. 长春中医药大学学报,2023,39(11):1275-1279. 王龙, 王广军, 梁群. 重症肺炎发病机制及中西医治疗研究进展[J]. 长春中医药大学学报, 2023, 39（11）: 1275-1279.
[6]	Wu X, Lu W, Wang T, et al. Optimization strategy for the early timing of bronchoalveolar lavage treatment for children with severe mycoplasma pneumoniae pneumonia[J]. BMC Infect Dis,2023,23(1):661-672.
[7]	Xu X H,Fan H F,Shi T T,et al. Influence of the timing of bronchoscopic alveolar lavage on children with adenovirus pneumonia: A comparative study[J]. BMC Pulm Med,2021,21(1):363-372. doi: 10.1186/s12890-021-01708-y
[8]	Wang L,Xie Q,Xu S,et al. The role of flexible bronchoscopy in children with mycoplasma pneumoniae pneumonia[J]. Pediatr Res,2023,93(1):198-206. doi: 10.1038/s41390-021-01874-z
[9]	Wu X,Lu W,Sang X,et al. Timing of bronchoscopy and application of scoring tools in children with severe pneumonia[J]. Ital J Pediatr,2023,49(1):44-55. doi: 10.1186/s13052-023-01446-3
[10]	Wang Y,Liu K,Chen C,et al. Acetylcysteine and budesonide for the treatment of refractory mycoplasma pneumoniae pneumonia in children: A clinical observation[J]. Ital J Pediatr,2023,49(1):80-89. doi: 10.1186/s13052-023-01491-y
[11]	Liu H,Wang W,Gao X,et al. Comparison of the efficacy of ambroxol hydrochloride and N -acetylcysteine in the treatment of children with bronchopneumonia and their influence on prognosis[J]. Exp Ther Med,2020,20(6):130-137.
[12]	中华人民共和国国家卫生健康委员会. 儿童社区获得性肺炎诊疗规范(2019年版)[J]. 中国实用乡村医生杂志,2019,26(4):6-13.
[13]	国家卫生健康委员会人才交流服务中心儿科呼吸内镜诊疗技术专家组,中国医师协会儿科医师分会内镜专业委员会,中国医师协会内镜医师分会儿科呼吸内镜专业委员会,等. 中国儿科可弯曲支气管镜术指南(2018年版)[J]. 中华实用儿科临床杂志,2018,33(13):983-989. doi: 10.3760/cma.j.issn.2095-428X.2018.13.006
[14]	吴晓凤,蒋敏,徐加威. 血清sCD14-ST在细菌性肺炎患儿中的表达及其与病原菌感染种类和疾病转归的关系[J]. 国际检验医学杂志,2023,44(24):2992-2995.
[15]	Zhu Z,Zhang T,Guo W,et al. Clinical characteristics of refractory Mycoplasma pneumoniae pneumonia in children treated with glucocorticoid pulse therapy[J]. BMC Infect Dis,2021,21(1):126-133. doi: 10.1186/s12879-021-05830-4
[16]	Zhang H F,Zhang X,Sha Y X,et al. Value of sTREM-1 in serum and bronchoalveolar lavage fluid,APACHE II score,and SOFA score in evaluating the conditions and prognosis of children with severe pneumonia[J]. Zhongguo Dang Dai Er Ke Za Zhi,2020,22(6): 626-631.
[17]	GBD 2015 LRICollaborators. Estimates of the global,regional,and national morbidity,mortality,and aetiologies of lower respiratory tract infections in 195 countries: a systematic analysis for the global burden of disease study 2015[J]. Lancet Infect Dis,2017,17(11):1133-1161. doi: 10.1016/S1473-3099(17)30396-1
[18]	Tong L,Huang S,Zheng C,et al. Refractory mycoplasma pneumoniae pneumonia in children: early recognition and management[J]. J Clin Med,2022,11(10):2824-2837. doi: 10.3390/jcm11102824
[19]	Zhang Y,Chen Y,Chen Z,et al. Effects of bronchoalveolar lavage on refractory Mycoplasma pneumoniae pneumonia[J]. Respir Care,2014,59(9):1433-1439. doi: 10.4187/respcare.03032
[20]	Jing Liu,Hui-Rong Zhao,Hua-Li Wei,et al. Efficacy of bronchoalveolar lavage as adjunct therapy in the treatment of neonatal severe pneumonia: a prospective case-control study[J]. Journal of Tropical Pediatrics,2020,66(5):528-533. doi: 10.1093/tropej/fmaa010
[21]	Paraskevas T,Kantanis A,Karalis I,et al. N-acetylcysteine efficacy in patients hospitalized with COVID-19 pneumonia: a systematic review and meta-analysis[J]. Rom J Intern Med,2023,61(1):41-52.
[22]	Y ü cel G,Zhao Z,El-Battrawy I,et al. Lipopolysaccharides induced inflammatory responses and electrophysiological dysfunctions in human-induced pluripotent stem cell derived cardiomyocytes[J]. Sci Rep,2017,7(1):29-35. doi: 10.1038/s41598-017-03147-4
[23]	Stravitz R T,Sanyal A J,Reisch J,et al. Effects of N-acetylcysteine on cytokines in non-acetaminophen acute liver failure: Potential mechanism of improvement in transplant-free survival[J]. Liver Int,2013,33(9):1324-1331. doi: 10.1111/liv.12214
[24]	Zhang R H,Li C H,Wang C L,et al. N-acetyl-l-cystine (NAC) protects against H9N2 swine influenza virus-induced acute lung injury[J]. Int Immunopharmacol,2014,22(1):1-8. doi: 10.1016/j.intimp.2014.06.013
[25]	Yang J, Shi J, Guan X, et al. Heme oxygenase-1 (HO-1) gene knockout affects the balance of lung immune cell composition and aggravates inflammatory injury in lung tissues of LPS-induced acute lung injury (ALI) mice[J]. Xi Bao Yu Fen Zi Mian Yi Xue Za Zhi,2024,40(4):296-302.
[26]	Chen H,Ma N,Song X,et al. Protective effects of N-Acetylcysteine on lipopolysaccharide-induced respiratory inflammation and oxidative stress[J]. Antioxidants (Basel),2022,11(5):879-895. doi: 10.3390/antiox11050879
[27]	张春玲,冯梦杰. 乙酰半胱氨酸辅助治疗重症支气管肺炎患儿的疗效及对潮气呼吸肺功能、免疫功能的影响[J]. 临床研究,2024,32(1):102-105.
[28]	Jannatifar R,Parivar K,Roodbari N H,et al. Effects of N-acetyl-cysteine supplementation on sperm quality,chromatin integrity and level of oxidative stress in infertile men[J]. Reprod. Biol. Endocrinol,2019,17(1):24-33. doi: 10.1186/s12958-019-0468-9

Relative Articles(20)

Relative Articles

[1]	Wei HU, Jinnan LI, Wei YANG, Li SU, Zhuo YU, Zhisong CHEN. Interventional Treatment of Muscular Ventricular Septal Defect in Children. Journal of Kunming Medical University, 2024, 45(3): 48-53. doi: 10.12259/j.issn.2095-610X.S20240307
[2]	Ruoyu WANG, Wei CHEN, Xun XU, Wende CAO, Yulan MIAO. Epidemiological Investigation and Risk Factors Analysis of Systemic Inflammatory Response Syndrome in 329 Children with Burn. Journal of Kunming Medical University, 2024, 45(5): 123-129. doi: 10.12259/j.issn.2095-610X.S20240519
[3]	Man YANG, Xingan ZHAO, Yunna GE, Juan QIN, Xiya WANG, Siming TAO. Identification of Atrial Fibrillation-related Inflammatory Genes and Their Association with Immune Cell Infiltration Based on Comprehensive Bioinformatic Analysis. Journal of Kunming Medical University, 2024, 45(3): 18-29. doi: 10.12259/j.issn.2095-610X.S20240303
[4]	Yang ZENG, Qian WANG, Maoliang TIAN. The Effect of Bronchoalveolar Lavage Combined with Low Molecular Weight Heparin on Patients with Severe Pneumonia. Journal of Kunming Medical University, 2024, 45(5): 151-156. doi: 10.12259/j.issn.2095-610X.S20240523
[5]	Xingzhu LIU, Yanfei YANG, Xing ZHANG, Liping GE, Feng WANG, Yuqin WU. Analysis of Lipid Metabolism Levels and Related Factors in Children with Kawasaki Disease in Different Courses. Journal of Kunming Medical University, 2023, 44(2): 113-119. doi: 10.12259/j.issn.2095-610X.S20230211
[6]	Xiaoli SHANG, Junxue NI, Yeying WANG, Jiao SHAN, Na BAI, Song WANG. Clinical Epidemiological Characteristics of Mycoplasma Pneumoniae and Its Correlation with Climatic Environment. Journal of Kunming Medical University, 2023, 44(6): 97-101. doi: 10.12259/j.issn.2095-610X.S20230618
[7]	Yaling ZHAO, Kun WU, Kai WANG, Rong HUANG, Genya HE, Yuhui NA, Miao HE, Zhenbo DING, Caiying ZHANG. Influence of Intrauterine Hyperglycemia Environment on Peripheral Inflammatory Response in Offspring of Gestational Diabetes Mellitus. Journal of Kunming Medical University, 2023, 44(11): 70-75. doi: 10.12259/j.issn.2095-610X.S20231110
[8]	Weijie LI, Liqin CHEN, Yaling LI, Yonghui HAN, Xiaojuan LI, Fendong YAN. Epidemiology, Clinical Characteristics and Risk Factors of 148 Severe Pertussis Cases in Yunnan. Journal of Kunming Medical University, 2022, 43(8): 145-149. doi: 10.12259/j.issn.2095-610X.S20220824
[9]	Jun-jie LI, Hai-yan JIANG, Wen-ya BAI, Si-ying HUO, Zhi-sheng SUN, Jian-lin SHAO. Effects of Silencing RND3 Expression on the Inflammatory Response and Apoptosis of Hippocampal Neurons Injured by Oxygen Glucose Deprivation/Reoxygenation. Journal of Kunming Medical University, 2021, 42(10): 14-21. doi: 10.12259/j.issn.2095-610X.S20211012
[10]	Shu-lan SHI, Xi-ting DAI, Guang-zhou ZHAO, Xiao Juan LI, Rong-jie LI, Ming-biao MA. Application of 16SrRNA Gene Detection in the Early Diagnosis of Bacterial Meningitis in Children. Journal of Kunming Medical University, 2021, 42(5): 120-125. doi: 10.12259/j.issn.2095-610X.S20210522
[11]	Song-tao BIN, Ming LI, Li TAN, Cheng-qing WU, Ji WANG, Xiao-qin HU. Clinical Analysis of 46 Children with Necrotizing Pneumonia. Journal of Kunming Medical University, 2021, 42(1): 124-129. doi: 10.12259/j.issn.2095-610X.S20210102
[12]	Sun Jian Ming , Dong Fang . Adverse Reactions in Children with Acute Lymphoblastic Leukemia after Chemotherapy. Journal of Kunming Medical University, 2017, 38(10): 107-111.
[13]	Qiu Wei , Chen Ying , Hu Xiu , Zhao Hong Yu . Analysis on Current Situation and Influencing Factors of Lead Poisoning in Children and Adolescents in Certain Region of Yunnan. Journal of Kunming Medical University, 2016, 37(11): 18-22.
[14]	Dai Mei . Risk Factors for Asthma in Children in Kunming City， China. Journal of Kunming Medical University,
[15]	Li Fei . Effect of Celebrex on the Hemorheology and Levels of Inflammatory Factors in Patients with Delayed Fracture Healing. Journal of Kunming Medical University,
[16]	Yang Shao Ling . . Journal of Kunming Medical University,
[17]	Bai Zhi Yao . . Journal of Kunming Medical University,
[18]	Sheng Xiao Cui . . Journal of Kunming Medical University,
[19]	He Li Yun . . Journal of Kunming Medical University,
[20]	. . Journal of Kunming Medical University,