Q: Mucolytics should be used in all acute respiratory failure patients requiring ventilator?
A recent metanalysis consisting of 13 randomized controlled trials (RCTs) consisting of 1712 patients failed to show any benefit of mucolytics in ARDS and acute respiratory failure patients who require ventilator. Four different mucoactive agents were investigated in these RCTs.
There was a slight favor towards decrease ICU stay, otherwise there was no effect on ventilator days, ventilator-free days, hospital stay or mortality.
Reference:Anand R, McAuley DF, Blackwood B, et al. Mucoactive agents for acute respiratory failure in the critically ill: a systematic review and meta-analysis. Thorax 2020; 75:623.