Abstract
OBJECTIVE: To evaluate the therapeutic efficacy of inhaled N-acetylcysteine (NAC) bronchoalveolar lavage (iNAC-BAL) in severe pneumonia (SP) and explore its effects on inflammatory cytokines modulation. METHODS: A total of 146 SP cases were assigned to two groups: the control group received bronchoalveolar lavage with isotonic saline (0.9% NaCl) alone, while the observation group received additional NAC aerosol inhalation. Clinical efficacy, Acute Physiology and Chronic Health Evaluation (APACHE) II scores, intensive care unit (ICU) stay, duration of ventilator dependence, adverse reactions, symptom resolution times, respiratory mechanics, pulmonary function, inflammatory cytokines, and humoral immunity were assessed and compared between the two groups. RESULTS: The observation group achieved better therapeutic effects (P=0.007), with significantly lower APACHE II scores, shorter ICU stays, reduced ventilator dependence, faster symptom resolution, and fewer adverse events (all P<0.05). Additionally, respiratory dynamics, lung function, inflammatory cytokines, and humoral immunity improved markedly in the observation group compared with the control group (all P<0.05). CONCLUSION: iNAC-BAL demonstrates significant clinical efficacy and potent anti-inflammatory effects in the management of SP.