To observe the clinical efficacy and safety of the application of bromhexine hydrochloride injection combined with high-flow nasal cannula oxygen therapy in children with severe pneumonia complicated with type I respiratory failure.

Children with severe pneumonia complicated with type I respiratory failure who were treated in our hospital were collected and divided into control group and treatment group based on the treatment methods. The control group received conventional oxygen therapy on the basis of conventional treatment, while the treatment group was given bromhexine hydrochloride and glucose injection (2~4 mg each time, qd, intravenous drip) combined with high-flow nasal cannula oxygen therapy on the basis of conventional treatment. Both groups were treated for 7 days. The clinical efficacy, respiratory and circulatory indicators, and inflammatory indicators of the two groups were compared, and safety was evaluated.

A total of 94 children were included, including 49 in control group and 45 in treatment group. After treatment, the overall clinical response rates were 75.51% (37 cases/49 cases) in control group and 91.11% (41 cases /45 cases) in treatment group, demonstrating a statistically significant difference (P<0.05). After treatment, the arterial partial pressure of oxygen (PaO₂) levels of control group and treatment group were (75.43±7.71) and (80.35±8.63) mmHg, respectively; the percutaneous oxygen saturation (SpO₂) levels were (94.16±2.06)% and (95.31±2.33)%, respectively; the PaO₂/FiO₂ levels were 327.08±34.36 and 342.40±33.53, respectively; the respiratory rate (RR) levels were (30.16±3.39) and (28.33±3.03) time·min^-1, respectively; the lactate levels were (2.66±0.43) and (2.38±0.34) mmol·L^-1, respectively; the interleukin-6 (IL-6) levels were (14.45±3.37) and (12.64±3.31) pg·mL^-1, respectively; the white blood cell (WBC) levels were (7.94±2.13) and (7.07±1.87) ×10⁹·L^-1, respectively; the neutrophil percentage (NEUT%) levels were (55.36±8.25)% and (51.58±7.43)%, respectively; the procalcitonin (PCT) levels were (0.17±0.04) and (0.15±0.04) ng·mL^-1, respectively, all differences between the two groups were statistically significant (P<0.05, P<0.01). The main adverse drug reactions in control group were facial skin damage, nasal mucosa damage and abdominal distension; the main adverse drug reactions in treatment group were nausea, vomiting, facial skin damage and nasal mucosa damage. The total incidence of adverse drug reactions in control group and treatment group were 14.29% (7 cases/49 cases) and 11.11% (5 cases/45 cases), respectively, with no statistically significant difference (P>0.05).

The treatment plan of bromhexine hydrochloride and glucose injection combined with high-flow nasal cannula oxygen therapy for children with severe pneumonia complicated with type Ⅰ respiratory failure is effective. It can significantly improve clinical symptoms, shorten the time of symptom relief, improve respiratory and circulatory indicators, reduce inflammatory indicators, promote the absorption of pneumonia, improve treatment comfort, shorten hospital stay and has good safety.