The use of pulmonary clearance medications in the acutely ill patient

ABSTRACT

Introduction: Retention of airway secretions occurs in disease, leading to airway plugging, atelectasis, and worsened respiratory mechanics, making airway clearance an important therapeutic target.

Areas covered: Many medications designed to enhance clearance of airway secretions are available. We will review the medications available to enhance airway clearance, their mechanisms of action, and the evidence available for their use in acutely ill patients.

Expert commentary: In the cystic fibrosis (CF) population, beneficial effects have been shown in pulmonary function with the use of some of these agents. In the non-CF population, there is limited evidence regarding these medications. While some studies have found benefit, the quality of evidence is low, making it difficult to draw conclusions. While certain patients may derive benefit, the general use of these medications in acutely ill patients without CF cannot be recommended at this time.

KEYWORDS:

• Airway secretions
• hypertonic saline
• mucolytics
• mucus
• pulmonary clearance
• sputum

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Additional information

Funding

This manuscript has not been funded.