Pharmacologic Agents That Promote Airway Clearance in Hospitalized Subjects: A Systematic Review.

Pharmacologic agents to promote mucus clearance may reduce the sequelae of obstructive secretions. We systematically reviewed comparative studies of pharmacologic agents for mucus clearance in hospitalized or postoperative subjects without cystic fibrosis and over 12 months of age. We searched MEDLI...

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Publicado en:Respiratory Care Vol. 60; no. 7; pp. 1061 - 1071
Autores principales: Sathe, Nila A., Krishnaswami, Shanthi, Andrews, Jeff, Ficzere, Cathy, McPheeters, Melissa L.
Formato: research systematic review tables/charts Journal Article
Publicado: Mary Ann Liebert, Inc. Jul2015
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Mary Ann Liebert, Inc.
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        atl: Pharmacologic Agents That Promote Airway Clearance in Hospitalized Subjects: A Systematic Review.
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          Sathe, Nila A.
          Krishnaswami, Shanthi
          Andrews, Jeff
          Ficzere, Cathy
          McPheeters, Melissa L.
        affil: Vanderbilt Evidence-based Practice Center, Institute for Medicine and Public Health; Department of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee
      sug:
        subj:
          Airway Management
          Inpatients
          Mucus Drug Effects
          Mucociliary Clearance
          Expectorants Therapeutic Use
          Human
          Systematic Review
          Medline
          Acetylcysteine Therapeutic Use
          Heparin Therapeutic Use
          Albuterol Therapeutic Use
          Ipratropium Therapeutic Use
          Aged
          Adult
          Middle Age
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          Child
          Adolescence
          Male
          Female
          Aged: 65+ years
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged, 80 & over
          Child, Preschool: 2-5 years
          Child: 6-12 years
          Adolescent: 13-18 years
          Male
          Female
      ab: Pharmacologic agents to promote mucus clearance may reduce the sequelae of obstructive secretions. We systematically reviewed comparative studies of pharmacologic agents for mucus clearance in hospitalized or postoperative subjects without cystic fibrosis and over 12 months of age. We searched MEDLINE and other databases from January 1970 to July 2014 to identify relevant literature. Two reviewers independently assessed each study against predetermined inclusion/exclusion criteria. Two reviewers also independently extracted data regarding subject and intervention characteristics and outcomes and assigned overall quality ratings. The 9 studies meeting review criteria included 5 randomized controlled trials, 3 crossover randomized controlled trials, and one retrospective cohort study. Studies were small and together included a total of 379 subjects (mean of 42 subjects per study). N-acetylcysteine, heparin plus N-acetylcysteine, albuterol, ipratropium bromide, and saline were assessed. Studies reported no benefit of studied agents on expectoration, pulmonary function, and atelectasis and little effect on changes in sputum volume, weight, or viscosity. Adverse effects of agents were not consistently reported. Nausea was reported in 2 studies of N-acetylcysteine (one paper reported 2 experiments and did not clearly identify in which experiment adverse effects occurred), 3 studies reported that there were no adverse events, and 3 studies did not address adverse effects at all. Further research with clearly characterized populations and interventions is needed to understand the potential benefits and adverse effects of mucoactive agents.
      pubtype: Academic Journal
      doctype:
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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