An evaluation of the effect of nebulized N-acetylcysteine on sputum consistency

Abstract

In order to ascertain the effectiveness of N-acetylcysteine (N-ac) as an expectorant, nebulized N-ac in 10 and in 20 per cent concentrations were compared with nebulized saline in a group of 70 patients with chronic obstructive pulmonary disease. Sputum volume and consistency were determined by a new method before and after nebulization through an intermittent positive pressure breathing apparatus in all patients. Spirometry was performed before and after nebulization in 47 patients. It was concluded that nebulized N-acetylcysteine is more effective than saline in thinning sputum and increasing volume and that 10 per cent N-ac is as effective as 20 per cent. Most patients failed to show spirometric changes as a result of either saline or N-ac nebulization. In those cases with decreased spirometric values, N-acetylcysteine was associated with obstruction in more cases than was saline; 10 per cent N-ac was less frequently associated with bronchial obstruction than was the 20 per cent concentration.