Ching PR, Pedersen LL. Severe pneumonia. Med Clin North Am. 2025;109(3):705–20.

Article  PubMed  Google Scholar 

Jambo A, Gashaw T, Mohammed AS, Edessa D. Treatment outcomes and its associated factors among pneumonia patients admitted to public hospitals in Harar, Eastern ethiopia: a retrospective follow-up study. BMJ Open. 2023;13(2):e065071.

Article  PubMed  PubMed Central  Google Scholar 

Moldoveanu B, Otmishi P, Jani P, Walker J, Sarmiento X, Guardiola J, et al. Inflammatory mechanisms in the lung. J Inflamm Res. 2009;2:1–11.

CAS  PubMed  Google Scholar 

Arias-Fernandez L, Gil-Prieto R, Gil-de-Miguel A. Incidence, mortality, and lethality of hospitalizations for community-acquired pneumonia with comorbid cardiovascular disease in Spain (1997–2015). BMC Infect Dis. 2020;20(1):477.

Article  PubMed  PubMed Central  Google Scholar 

Jain S, Self WH, Wunderink RG, Fakhran S, Balk R, Bramley AM, et al. Community-Acquired pneumonia requiring hospitalization among U.S. Adults. N Engl J Med. 2015;373(5):415–27.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Putot A, Garin N, Rello J, Prendki V. European study group of infections in the elderly P. Comprehensive management of pneumonia in older patients. Eur J Intern Med. 2025;135:14–24.

Article  PubMed  Google Scholar 

Eurich DT, Marrie TJ, Minhas-Sandhu JK, Majumdar SR. Risk of heart failure after community acquired pneumonia: prospective controlled study with 10 years of follow-up. BMJ. 2017;356:j413.

Article  PubMed  PubMed Central  Google Scholar 

Ziaeian B, Fonarow GC. Epidemiology and aetiology of heart failure. Nat Rev Cardiol. 2016;13(6):368–78.

Article  PubMed  PubMed Central  Google Scholar 

Liu H, Wang W, Gao X. Comparison of the efficacy of ambroxol hydrochloride and N -acetylcysteine in the treatment of children with Bronchopneumonia and their influence on prognosis. Exp Ther Med. 2020;20(6):130.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Cheng L, Liu M, Wang R, Cao S, Li R, Su B, et al. Ambroxol hydrochloride spray (Luo Runchang(R)) in the treatment of acute respiratory infectious diseases: a prospective, multicenter, open label, randomized controlled study. Front Pediatr. 2024;12:1380189.

Article  PubMed  PubMed Central  Google Scholar 

Li M, Bao J, Yang L. The clinical efficacy of combining ambroxol hydrochloride with antibiotics for the treatment of chronic bronchitis. Altern Ther Health Med. 2025;31(1):161–7.

PubMed  Google Scholar 

Tang H, Yuan Z, Li J, Wang Q, Fan W. The application of ambroxol hydrochloride combined with fiberoptic bronchoscopy in elderly patients with severe pneumonia: A meta-analysis and systematic review. Med (Baltim). 2022;101(4):e28535.

Article  CAS  Google Scholar 

Li Z. The effect of adjuvant therapy with ambroxol hydrochloride in elderly chronic obstructive pulmonary disease patients. Am J Transl Res. 2021;13(8):9285–95.

CAS  PubMed  PubMed Central  Google Scholar 

Molyneaux PL, Cox MJ, Willis-Owen SA, Mallia P, Russell KE, Russell AM, et al. The role of bacteria in the pathogenesis and progression of idiopathic pulmonary fibrosis. Am J Respir Crit Care Med. 2014;190(8):906–13.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Alruhaimi RS, Hassanein EHM, Alnasser SM, Ahmeda AF, Althagafy HS, Allam AMT, et al. Modulation of NF-kappaB/NLRP3 inflammasome axis, Nrf2/HO-1 signaling and Attenuation of oxidative stress mediate the protective effect of ambroxol against cyclophosphamide cardiotoxicity. Biochem Biophys Res Commun. 2025;776:152242.

Article  CAS  PubMed  Google Scholar 

Metlay JP, Waterer GW. Update in adult community-acquired pneumonia: key points from the new American thoracic society/Infectious diseases society of America 2019 guideline. Curr Opin Pulm Med. 2020;26(3):203–7.

Article  PubMed  Google Scholar 

Heart Failure Group of Chinese Society of Cardiology of Chinese Medical. Chinese heart failure association of Chinese medical Doctor A, editorial board of Chinese journal of C. [Chinese guidelines for the diagnosis and treatment of heart failure 2018]. Zhonghua Xin Xue Guan Bing Za Zhi. 2018;46(10):760–89.

Google Scholar 

Metlay JP, Waterer GW, Long AC, Anzueto A, Brozek J, Crothers K, et al. Diagnosis and treatment of adults with Community-acquired Pneumonia. An official clinical practice guideline of the American thoracic society and infectious diseases society of America. Am J Respir Crit Care Med. 2019;200(7):e45–67.

Article  PubMed  PubMed Central  Google Scholar 

He XD, Wang Y, Wu Q, Wang HX, Chen ZD, Zheng RS, et al. Xuebijing protects rats from sepsis challenged with acinetobacter baumannii by promoting Annexin A1 expression and inhibiting Proinflammatory cytokines secretion. Evid Based Complement Alternat Med. 2013;2013:804940.

Article  PubMed  PubMed Central  Google Scholar 

Kang N, Subramanian VS, Agrawal A. Influence of aging and immune alterations on susceptibility to Pneumococcal pneumonia in the elderly. Pathogens. 2025;14(1).

Aliberti S, Ramirez JA. Cardiac diseases complicating community-acquired pneumonia. Curr Opin Infect Dis. 2014;27(3):295–301.

Article  CAS  PubMed  Google Scholar 

Yang R, Duan Y, Wang D, Liu Q. Developing a preliminary clinical prediction model for prognosis of pneumonia complicated with heart failure based on metagenomic sequencing. Crit Care Res Pract. 2023;2023:5930742.

PubMed  PubMed Central  Google Scholar 

Shen L, Jhund PS, Anand IS, Bhatt AS, Desai AS, Maggioni AP, et al. Incidence and outcomes of pneumonia in patients with heart failure. J Am Coll Cardiol. 2021;77(16):1961–73.

Article  PubMed  Google Scholar 

Corrales-Medina VF, Taljaard M, Yende S, Kronmal R, Dwivedi G, Newman AB, et al. Intermediate and long-term risk of new-onset heart failure after hospitalization for pneumonia in elderly adults. Am Heart J. 2015;170(2):306–12.

Article  PubMed  PubMed Central  Google Scholar 

Zhang H, Liu R. Effect of Bronchoalveolar lavage combined with high-dose ambroxol hydrochloride on severe pneumonia with respiratory failure. Am J Transl Res. 2025;17(9):7170–9.

Article  PubMed  PubMed Central  Google Scholar 

Zhang X, Zhang X, Gu J, Zhang L, Yang R. The efficacy of nebulized Budesonide and ambroxol hydrochloride in treating pediatric community-acquired pneumonia and their impact on clinical characteristics and inflammatory markers. J Health Popul Nutr. 2024;43(1):132.

Article  PubMed  PubMed Central  Google Scholar 

Wahidi MM, Shojaee S, Lamb CR, Ost D, Maldonado F, Eapen G, et al. The use of bronchoscopy during the coronavirus disease 2019 pandemic: CHEST/AABIP guideline and expert panel report. Chest. 2020;158(3):1268–81.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Zhou XY, Ben SQ, Chen HL, Ni SS. A comparison of APACHE II and CPIS scores for the prediction of 30-day mortality in patients with ventilator-associated pneumonia. Int J Infect Dis. 2015;30:144–7.

Article  PubMed  Google Scholar 

Du X, Zhao C, Liu S, Su S. Value of ambroxol in the treatment of asthmatic bronchitis. Pak J Med Sci. 2020;36(3):501–4.

Article  PubMed  PubMed Central  Google Scholar 

Li A, Li J, Bao Y, Yuan D, Huang Z. Xuebijing injection alleviates cytokine-induced inflammatory liver injury in CLP-induced septic rats through induction of suppressor of cytokine signaling 1. Exp Ther Med. 2016;12(3):1531–6.

Article  PubMed  PubMed Central  Google Scholar 

Zanza C, Romenskaya T, Manetti AC, Franceschi F, La Russa R, Bertozzi G et al. Cytokine storm in COVID-19: Immunopathogenesis and therapy. Med (Kaunas). 2022;58(2).

Monton C, Torres A. Lung inflammatory response in pneumonia. Monaldi Arch Chest Dis. 1998;53(1):56–63.

CAS  PubMed  Google Scholar 

Guo H, Zheng J, Huang G, Xiang Y, Lang C, Li B, et al. Xuebijing injection in the treatment of COVID-19: a retrospective case-control study. Ann Palliat Med. 2020;9(5):3235–48.

Article  PubMed  Google Scholar 

Luo Z, Chen W, Xiang M, Wang H, Xiao W, Xu C, et al. The preventive effect of Xuebijing injection against cytokine storm for severe patients with COVID-19: A prospective randomized controlled trial. Eur J Integr Med. 2021;42:101305.

Article