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Evaluation of the Effect of Nebulized N-Acetylcysteine on Respiratory Secretions in Mechanically Ventilated Patients: Randomized Clinical Trial.

Masoompour SM, Anushiravani A, Tafaroj Norouz A - Iran J Med Sci (2015)

Bottom Line: Although the mean secretion density was significantly lower in the NAC group (F (1, 38)=8.61, P=0.006), but a repeated measures ANOVA with a Greenhouse-Geisser correction determined that the effect of NAC on mean secretion density did not differ significantly between time points (F (1, 38)=3.08, P=0.087).The peak airway pressure did not change significantly during the study in the normal saline and NAC groups (F (1.52, 56.4)=0.91, P=0.384).Considering the limitations of the study, nebulized NAC in mechanically ventilated patients was not effective more than normal saline nebulization in reducing the density of mucous plugs.

View Article: PubMed Central - PubMed

Affiliation: Pulmonary and Critical Care Division, Department of Internal Medicine, Shahid Fahghihi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran;

ABSTRACT

Background: The purpose of our study was to evaluate an inexpensive and available method to reduce mucous impactions in mechanically ventilated patients.

Methods: This randomized clinical trial was conducted on 40 mechanically ventilated patients aged 15-90 years. The patients were randomly allocated into two arms; 20 cases and 20 controls. The cases received N-acetylcysteine via their nebulizers, and the control group received normal saline three times a day for one day. We measured the density of respiratory secretion, plateau and peak airway pressures, and O2 saturation at baseline, 12 and 24 hours later.

Results: Although the mean secretion density was significantly lower in the NAC group (F (1, 38)=8.61, P=0.006), but a repeated measures ANOVA with a Greenhouse-Geisser correction determined that the effect of NAC on mean secretion density did not differ significantly between time points (F (1, 38)=3.08, P=0.087). NAC increased O2 saturation significantly between time points (F (1.92, 73.1)=4.6, P=0.014). The plateau airway pressures were relatively stable throughout the study in the normal saline and NAC groups (F (1.95, 37.1)=0.67, P=0.513). The peak airway pressure did not change significantly during the study in the normal saline and NAC groups (F (1.52, 56.4)=0.91, P=0.384).

Conclusion: Considering the limitations of the study, nebulized NAC in mechanically ventilated patients was not effective more than normal saline nebulization in reducing the density of mucous plugs. The peak and plateau airway pressures were relatively stable throughout the study in both groups.

Trial registration number: IRCT201104276312N1.

No MeSH data available.


Related in: MedlinePlus

CONSORT diagram shows sampling procedures.
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Figure 1: CONSORT diagram shows sampling procedures.

Mentions: This randomized-controlled clinical trial was conducted in a 10-bed medical ICU at a teaching hospital in Shiraz, from January to the end of June 2012. We studied 40 sedated patients between 15-90 years old, intubated on arrival and mechanically ventilated for more than 72 hours. Patients were randomly allocated into two groups (20 patients per arm) using a computer-guided randomization table (figure 1). For this purpose, 40 cards were placed in a closed box, each having “case” or “control” written on it. Prior to the study, a card was pulled out of the box and a patient was labeled as the case or control.


Evaluation of the Effect of Nebulized N-Acetylcysteine on Respiratory Secretions in Mechanically Ventilated Patients: Randomized Clinical Trial.

Masoompour SM, Anushiravani A, Tafaroj Norouz A - Iran J Med Sci (2015)

CONSORT diagram shows sampling procedures.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4487455&req=5

Figure 1: CONSORT diagram shows sampling procedures.
Mentions: This randomized-controlled clinical trial was conducted in a 10-bed medical ICU at a teaching hospital in Shiraz, from January to the end of June 2012. We studied 40 sedated patients between 15-90 years old, intubated on arrival and mechanically ventilated for more than 72 hours. Patients were randomly allocated into two groups (20 patients per arm) using a computer-guided randomization table (figure 1). For this purpose, 40 cards were placed in a closed box, each having “case” or “control” written on it. Prior to the study, a card was pulled out of the box and a patient was labeled as the case or control.

Bottom Line: Although the mean secretion density was significantly lower in the NAC group (F (1, 38)=8.61, P=0.006), but a repeated measures ANOVA with a Greenhouse-Geisser correction determined that the effect of NAC on mean secretion density did not differ significantly between time points (F (1, 38)=3.08, P=0.087).The peak airway pressure did not change significantly during the study in the normal saline and NAC groups (F (1.52, 56.4)=0.91, P=0.384).Considering the limitations of the study, nebulized NAC in mechanically ventilated patients was not effective more than normal saline nebulization in reducing the density of mucous plugs.

View Article: PubMed Central - PubMed

Affiliation: Pulmonary and Critical Care Division, Department of Internal Medicine, Shahid Fahghihi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran;

ABSTRACT

Background: The purpose of our study was to evaluate an inexpensive and available method to reduce mucous impactions in mechanically ventilated patients.

Methods: This randomized clinical trial was conducted on 40 mechanically ventilated patients aged 15-90 years. The patients were randomly allocated into two arms; 20 cases and 20 controls. The cases received N-acetylcysteine via their nebulizers, and the control group received normal saline three times a day for one day. We measured the density of respiratory secretion, plateau and peak airway pressures, and O2 saturation at baseline, 12 and 24 hours later.

Results: Although the mean secretion density was significantly lower in the NAC group (F (1, 38)=8.61, P=0.006), but a repeated measures ANOVA with a Greenhouse-Geisser correction determined that the effect of NAC on mean secretion density did not differ significantly between time points (F (1, 38)=3.08, P=0.087). NAC increased O2 saturation significantly between time points (F (1.92, 73.1)=4.6, P=0.014). The plateau airway pressures were relatively stable throughout the study in the normal saline and NAC groups (F (1.95, 37.1)=0.67, P=0.513). The peak airway pressure did not change significantly during the study in the normal saline and NAC groups (F (1.52, 56.4)=0.91, P=0.384).

Conclusion: Considering the limitations of the study, nebulized NAC in mechanically ventilated patients was not effective more than normal saline nebulization in reducing the density of mucous plugs. The peak and plateau airway pressures were relatively stable throughout the study in both groups.

Trial registration number: IRCT201104276312N1.

No MeSH data available.


Related in: MedlinePlus