Abstract
Objective: To determine the role of nebulized N-acetylcysteine in mechanical ventilation in clearing the airway of these patients Study Design: A Randomized Control Trial. Place and Duration of Study: Department of Anaesthesia and Intensive Care Unit Nishtar Medical University Hospital and Jinnah Hosptal, Lahore. From January 2017 to July 2018. Material and Methods: In this project total 50 patients were enrolled by consecutive sampling who remained on mechanical ventilation for more than 24 hours and were between ages 15 to 80 years old. Written consent of this project was taken from relative of each patient. These patients were divided into two groups by lottery method into case and control. The case group received 2 ml of NAC 20% with 8 ml normal saline 3 times a day for 1 day. The control group only received 10 ml normal saline via their nebulizers 3 times a day at 8 AM, 2 PM, and 9 PM. Data was collected and was analyzed. SPSS 22 was used for this purpose. All numerical variables of this research such as mean FiO 2 , mean peak and plateau pressure of airway, mean blood pressure, mean age and importantly mean density of secretions were calculated. In these values t test was applied and p value was calculated. If it was less than .005, then it was considered significant. Similarly, qualitative data such as type of disease were calculated in percentage and chi square test was used to check the significance. Results: The mean O2 saturation of baseline, 12 hours and 24 hours of the controls was 93.84±2.28, 94.27±2.33 and 94.08±1.81 respectively. The mean peak airway pressure of baseline, 12 hours and 24 hours of the controls was 23.16±3.49, 25.38±8.86 and 24.01±4.91 respectively. The mean plateau airway pressure of baseline, 12 hours and 24 hours of the controls was 19.04±7.79, 21.37±4.86 and 21.85±8.93 respectively. The mean secretion density of baseline, 12 hours and 24 hours of the controls was 1.04±0.024, 1.05±0.03 and 1.03±0.002 respectively. While, the mean O2 saturation of baseline, 12 hours and 24 hours of the cases was 93.08±2.37, 94.61±2.56 and 94.11±2.34 respectively. The mean peak airway pressure of baseline, 12 hours and 24 hours of the cases was 26.58±5.81, 23.81±8.28 and 24.34±6.15 respectively. The mean plateau airway pressure of baseline, 12 hours and 24 hours of the cases was 21.88±78.01, 24.88±6.67 and 23.51±7.55 respectively. The mean secretion density of baseline, 12 hours and 24 hours of the cases was 1.01±0.021, 1.08±0.022 and 1.008±0.0195 respectively. The differences were statistically insignificant. P-value ≤ 0.05 is considered as significant. Conclusion: It is concluded from our observations that use of N-acetylcysteine in patients on mechanical ventilation is very effective in clearance of secretion and to maintain airway clear. Key words: N-acetylcysteine, mechanical ventilation, airway clearance, normal saline DOI : 10.7176/JMPB/54-07 Publication date : April 30 th 2019
Highlights
Maintaining the airway hygiene and clearing the airway secretions is very essential in preventing recurrent respiratory infections and maintaining airway patency
Material and Methods: In this project total 50 patients were enrolled by consecutive sampling who remained on mechanical ventilation for more than 24 hours and were between ages 15 to 80 years old
It is concluded from our observations that use of N-acetylcysteine in patients on mechanical ventilation is very effective in clearance of secretion and to maintain airway clear
Summary
Maintaining the airway hygiene and clearing the airway secretions is very essential in preventing recurrent respiratory infections and maintaining airway patency. In intensive care unit usually manual methods are used to facilitate airway clearance and some of them are confirmed as effective [1] Mucous plugs those are retained secretions in tracheobronchial tree are often observed in patients who are mechanically ventilated due to depressed mucociliary clearance, cough reflex and more production of sputum [2]. Medications such as anti-DNase are expensive and locally not available In this situation effective and cheap methods for clearing the airway was need of the hour to reduce retention of secretions in patients with mechanically ventilated. Its effects are not known if given by nebulization through endotracheal tube It was discovered by Sheffner et al first time the mucolytic qualities of N-acetylcysteine. After this it has been used in many situations as mucolytic drug [4]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
