Abstract: Objective To observe the therapeutic effect of inhaled acetylcysteine in the bronchoalveolar lavage treatment for the patients with severe pneumonia. Methods Sixty patients with severe pneumonia were randomly divided into the treatment and control groups according to the principle of baseline feature matching. All patients were given basic treatment such as mechanical ventilation, anti-infection, expectorant, and tracheoscopic bronchoalveolar lavage. The lavage fluid in the treatment group was inhaled acetylcysteine,and normal saline in the control group. The white blood cell (WBC), C-reactive protein (CRP), procalcitonin (PCT), oxygenation index (OI), respiratory mechanical indexes such as airway resistance (Raw), platform pressure (Pplat), positive end-expiratory pressure (PEEP), and dynamic lung compliance(Cdyn) were detected for the two groups before and after treatment. Moreover, treatment effective rate, mechanical ventilation time, and intensive care unit (ICU) retention time were compared with each other between the two groups. Results Before treatment: there were no significant differences in WBC, CRP, PCT, OI and respiratory mechanics indexes between the two groups (P>0.05). After treatment, WBC, CRP, PCT, RAW, PPLAT and PEEP in the treatment group were significantly decreased compared with that in the control group (P<0.05).OI, Cdyn and effective rate in the treatment group were higher than those in the control group (P<0.05).The mechanical ventilation time and ICU retention time in the treatment group were shorter than that in the control group (P<0.05), and the differences were statistically significant. Conclusion The bronchoalveolar lavage with inhaled acetylcysteine may benefit inflammatory absorption and improve prognosis in patients with severe pneumonia.

Key words: acetylcysteine, bronchoalveolar lavage, severe pneumonia