RT Magazine reports the following:
A new evidence-based Clinical Practice Guideline (CPG) published in Respiratory Care found that evidence is lacking that proves pharmacologic agents routinely administered for airway clearance are effective in improving oxygenation and respiratory mechanics, reducing ventilator time and ICU stay, or resolving atelectasis.
The CPG is based on the work of an American Association for Respiratory Care (AARC) task force and Vanderbilt University researchers.The following are the new recommendations regarding use of aerosols for
- The routine use of aerosolized acetylcysteine (Mucomyst) to improve airway clearance is not recommended in hospitalized adult and pediatric patients.
- Aerosolized agents to change mucus biophysical properties or promote airway clearance are not recommended for adult or pediatric patients with neuromuscular disease, respiratory muscle weakness, or impaired cough.
- Mucolytics are not recommended to treat atelectasis in postoperative adult or pediatric patients, and the routine administration of bronchodilators to postoperative patients is not recommended.
- There is no high-level evidence related to the use of bronchodilators, mucolytics, mucokinetics, and novel therapy to promote airway clearance in the studied populations.
This is vindication, of sorts, to all of us RTs who have complained for years that this type of therapy rarely results in the desired benefits. We'll have to wait and see if the medical profession eventually catches on to this new wisdom. Using history as our guide, this will probably occur in the year 2035.