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Early administration of mucoactive agents and ventilator-free days: a propensity score-matched study

Jun Fujinaga1, Akira Kuriyama1, Mutsuo Onodera1,2

  • 1Emergency and Critical Care Center, Kurashiki Central Hospital, Kurashiki, Japan.

Annals of Translational Medicine
|April 3, 2023
PubMed
Abstract

Insights

Early use of mucoactive agents in mechanically ventilated patients did not improve ventilator-free days. This study found no significant difference in respiratory outcomes between early and on-demand administration of these airway secretion medications.

Area of Science:

  • Critical Care Medicine
  • Pulmonology
  • Pharmacology

Background:

  • Mucoactive agents are commonly used to manage airway secretions.
  • Their effectiveness in improving respiratory outcomes for mechanically ventilated patients remains uncertain.

Purpose of the Study:

  • To investigate the association between early administration of mucoactive agents and increased ventilator-free days (VFDs) in mechanically ventilated patients.

Main Methods:

  • Retrospective observational study in two Japanese ICUs.
  • Propensity score matching (1:1) comparing early vs. on-demand mucoactive agent groups.
  • Primary outcome: VFDs within 28 days of ICU stay.

Main Results:

  • 94 patients (47 per group) were analyzed after matching.
  • No significant difference in median VFDs between early (21 days) and on-demand (20 days) groups (P=0.53).
  • No significant difference in median ICU-free days between groups (19 days each).

Conclusions:

  • Early administration of mucoactive agents was not associated with improved VFDs in mechanically ventilated patients.
  • Current evidence does not support early use of mucoactive agents for enhanced recovery in this population.
Keywords:
Airway managementcritically illmechanical ventilationpropensity scoreventilator-free days (VFDs)

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