Effectiveness of Pharmacologic Airway Clearance Therapies in Hospitalized Patients

Publication Date: December 1, 2015
Last Updated: March 14, 2022

Recommendations

Hospitalized Adult and Pediatric Patients Without Cystic Fibrosis

  1. Recombinant human dornase alfa should not be used in adults and children with non-CF bronchiectasis.
  2. Routine use of bronchodilators to aid in secretion clearance is not recommended.
  3. Routine use of aerosolized N-acetylcysteine to improve airway clearance is not recommended.
6731

Adult and Pediatric Patients With Neuromuscular Disease, Respiratory Muscle Weakness, or Impaired Cough

The use of aerosolized agents to change sputum physical properties or improve airway clearance cannot be recommended for patients with NMD or weakness due to insufficient evidence.
6731

Postoperative Adult and Pediatric Patients

  1. Mucolytics cannot be recommended for use in the treatment of atelectasis due to insufficient evidence.
  2. Routine administration of bronchodilators to postoperative patients is not recommended.
6731

Recommendation Grading

Overview

Title

Effectiveness of Pharmacologic Airway Clearance Therapies in Hospitalized Patients

Authoring Organization

Publication Month/Year

December 1, 2015

Last Updated Month/Year

April 13, 2023

Supplemental Implementation Tools

Document Type

Guideline

External Publication Status

Published

Country of Publication

US

Document Objectives

The purpose of this guideline is to provide guidance to clinicians in the identification, selection, and delivery of medication for airway clearance. This guideline does not include the use of medication for patients with cystic fibrosis, as this has been addressed.

Target Patient Population

Patients require airway clearance therapy

Inclusion Criteria

Female, Male, Adolescent, Adult, Child, Older adult

Health Care Settings

Emergency care, Hospital

Intended Users

Nurse, nurse practitioner, physician, physician assistant

Scope

Assessment and screening, Management, Treatment

Diseases/Conditions (MeSH)

D006493 - Heparin, D058109 - Airway Management, D020545 - Respiratory Mucosa

Keywords

airway restriction, difficult airway, airway management, mucolytics

Source Citation

Respir Care 2015;60(7):1071–1077