The (Non) Role of Mucoactive Agents in Liberating Patients from Ventilators

Mucoactive agents often are used in patients in intensive care units (ICUs) to facilitate clearance of tenacious secretions, but we don’t have evidence of benefit (except among patients with cystic fibrosis). To determine whether mucoactive agents shortened duration of mechanical ventilation, researchers randomized 2000 mechanically ventilated patients with acute respiratory failure and difficult-to-clear secretions to enteral carbocisteine, nebulized hypertonic saline (6%–7%), both agents, or usual care at 70 ICU sites in the U.K.