Title : Adjunctive sublingual squalene in children with severe pneumonia admitted to the pediatric intensive care unit: A pilot randomized clinical trial

Objective: Severe pneumonia is a complex syndrome of lung injury, which may be characterized by clinical manifestations, pulmonary involvement, the presence of hypoxemia, and manifestations of pulmonary complications and extrapulmonary definition. Early, timely, and accurate identification of the causative pathogens, along with the selection of antimicrobial drugs, is critical to improve outcomes, reduce drug consumption, and reduce mortality in children. Squalene is a compound with the formula C30H50. Given the anti-inflammatory effects of squalene, we decided to investigate the effect of sublingual squalene on hospitalization and clinical course of pneumonia in patients hospitalized in the pediatric intensive care unit.

Methods & Materials: This study was conducted in the years 1402 to 1404 at Akbar Specialized and Superspecialized Children's Hospital of Mashhad on 52 patients with pneumonia. In this clinical trial study, in the intervention group, in addition to conventional antibiotic treatment, 10 mg of sublingual screen was given for up to 5 days, and in the control group, only drug treatment was used. Clinical outcomes included vital signs, GCS, treatment regimen, pupillary response, PRISM score, and mortality on days 0, 2, 4, and 6 after treatment, and exercises and chest radiography on days 1 and 6 of treatment were recorded in both groups and were evaluated between the two groups using the two-group comparison analysis method

Results: In this study, 13 boys (54.2%) were in the intervention group and 11 boys (45.8%) were in the control group, and no significant relationship was observed between the two groups. pvalue=0.58. The number of patients in the two groups was determined by the mean of 30.81±10.60 per minute (Pvalue=0.00). During the next 30 days, no significant relationship was observed between the two groups. (p=0.093) Serum CRP levels in the intervention group were 15.02±17.99 with a mean of 26.12±27.34 in the control group, and there was a significant relationship between the two. (Pvalue9=0).

Conclusion: Considering that pneumonia in children is one of the common acquired injuries in the community and the highest number of deaths occur in children. It gives, the need for effective treatment for rapid recovery and discharge of the patient from intensive care is of great concern. This study provides evidence for the improvement in clinical and laboratory symptoms in patients with pneumonia in the intensive care unit using squalene along with other routine biotic treatments.

Keywords: pneumonia, squalene, pediatric intensive care

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