N-乙酰半胱氨酸支气管肺泡灌洗对重度脑外伤合并呼吸机相关肺炎患者的价值

IF 0.7 4区 材料科学 Q3 Materials Science
Yujuan Li, Jing Lu
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引用次数: 0

摘要

为了改善严重创伤性脑损伤(TBI)呼吸机相关肺炎(VAP)患者的治疗,有效抑制炎症反应并提高血氧指标,我们采用 N-乙酰半胱氨酸(NAC)进行了创新性支气管肺泡灌洗(BAL)治疗。为了开展这项研究,我们将严重创伤性脑损伤 VAP 患者分为对照组(CTRL)和 BAL 组。对照组使用生理盐水进行 BAL,而 BAL 组在标准护理的基础上使用 NAC 进行 BAL。我们比较了两组在 BAL 前后的临床治疗、炎症程度、血氧指数和安全性。结果显示,使用 NAC 的 BAL 在缩短抗生素使用时间、影像学摄取、退热、机械通气、ICU 留观时间以及 CPIS 和 APACHE II 评分方面更为有效。此外,BAL 组患者的通气状况得到了更大改善,PaO2、SaO2 和 OI 值均有所上升,PaCO2 下降幅度更大。此外,BAL 治疗有效抑制了体内炎症反应的水平,更显著地降低了 TNF-α、CPR、PCT 和 MIP-1α 的水平。BAL 辅助治疗可有效改善严重创伤性脑损伤并伴有 VAP 患者的临床预后并降低死亡率,同时在 BAL 操作过程中保持较高的安全性。因此,使用 NAC 的 BAL 在抢救严重创伤性脑损伤合并 VAP 患者方面具有巨大潜力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The value of N-acetylcysteine bronchoalveolar lavage in patients with severe traumatic brain injury combined with ventilator-associated pneumonia
In order to improve the treatment of patients with ventilator-associated pneumonia (VAP) in severe traumatic brain injury (TBI) and to effectively suppress the inflammatory response and enhance blood oxygen indicators, we conducted an innovative bronchoalveolar lavage (BAL) treatment using N-acetylcysteine (NAC). To conduct this study, we divided patients with VAP in severe TBI into a control (CTRL) group and a BAL group. The control group received BAL with saline, while the BAL group received BAL with NAC in addition to standard care. We compared the clinical treatment, degree of inflammation, blood oxygen index, and safety of both groups pre- and post-BAL. The results showed that BAL with NAC was more effective in reducing the duration of antibiotic use, imaging uptake, fever reduction, mechanical ventilation, and ICU stay, as well as CPIS and APACHE II scores. Moreover, the BAL group demonstrated greater improvement in ventilation, as indicated by increased values of PaO2, SaO2, and OI, and a more substantial decrease in PaCO2. Furthermore, BAL treatment effectively suppressed the level of inflammatory response in the body and more significantly reduced TNF-α, CPR, PCT and MIP-1α levels. Adjuvant treatment with BAL effectively improved clinical outcomes and reduced mortality in severe TBI patients with VAP, while maintaining a high level of safety during the BAL operation. Therefore, BAL using NAC holds significant potential in the salvage of patients with severe TBI combined with VAP.
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来源期刊
Materials Express
Materials Express NANOSCIENCE & NANOTECHNOLOGY-MATERIALS SCIENCE, MULTIDISCIPLINARY
自引率
0.00%
发文量
69
审稿时长
>12 weeks
期刊介绍: Information not localized
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