Skip to main content
NCBI home page
Thorax logoLink to Thorax
. 1996 Apr;51(4):429–432. doi: 10.1136/thx.51.4.429

Evaluation of nebulised acetylcysteine and normal saline in the treatment of sputum retention following thoracotomy.

A M Gallon 1
PMCID: PMC1090682  PMID: 8733499

Abstract

BACKGROUND: The use of acetylcysteine as a mucolytic agent is controversial. In 1962 it was claimed to be "the most effective agent ... for the liquefaction of ... secretions" but was subsequently taken off the market as a respirator solution. Normal saline, on the other hand, is becoming increasingly popular. A study was undertaken to determine which solution is more effective at clearing retained secretions following thoracotomy. METHODS: The study included 10 patients and was of single blind, two-way crossover design. Measurements taken before and after each treatment included sputum viscosity, difficulty of expectoration, weight of sputum expectorated, and oxygen saturation. RESULTS: Following nebulisation of acetylcysteine, sputum viscosity was reduced, difficulty of expectoration was reduced, the weight of sputum expectorated was increased, and oxygen saturation was increased. There were no changes after nebulisation of normal saline. CONCLUSIONS: This study shows that, following thoracotomy, nebulised acetylcysteine reduces sputum viscosity, making expectoration easier and improving oxygenation. Nebulised normal saline has no effect.

Full text

PDF
429

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bartlett R. H., Gazzaniga A. B., Geraghty T. R. Respiratory maneuvers to prevent postoperative pulmonary complications. A critical review. JAMA. 1973 May 14;224(7):1017–1021. [PubMed] [Google Scholar]
  2. Boman G., Bäcker U., Larsson S., Melander B., Wåhlander L. Oral acetylcysteine reduces exacerbation rate in chronic bronchitis: report of a trial organized by the Swedish Society for Pulmonary Diseases. Eur J Respir Dis. 1983 Aug;64(6):405–415. [PubMed] [Google Scholar]
  3. Bylin G., Hedenstierna G., Lagerstrand L., Wagner P. D. No influence of acetylcysteine on gas exchange and spirometry in chronic asthma. Eur J Respir Dis. 1987 Aug;71(2):102–107. [PubMed] [Google Scholar]
  4. Conway J. H., Fleming J. S., Perring S., Holgate S. T. Humidification as an adjunct to chest physiotherapy in aiding tracheo-bronchial clearance in patients with bronchiectasis. Respir Med. 1992 Mar;86(2):109–114. doi: 10.1016/s0954-6111(06)80225-8. [DOI] [PubMed] [Google Scholar]
  5. Dark J. F., Mousalli H., Vaughan R. Surgical treatment of carcinoma of the oesophagus. Thorax. 1981 Dec;36(12):891–895. doi: 10.1136/thx.36.12.891. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Fairshter R. D., Williams J. H., Jr Pulmonary physiology in the postoperative period. Crit Care Clin. 1987 Apr;3(2):287–306. [PubMed] [Google Scholar]
  7. Gamsu G., Singer M. M., Vincent H. H., Berry S., Nadel J. A. Postoperative impairment of mucous transport in the lung. Am Rev Respir Dis. 1976 Oct;114(4):673–679. doi: 10.1164/arrd.1976.114.4.673. [DOI] [PubMed] [Google Scholar]
  8. Giordano A., Holsclaw D., Litt M. Effects of various drugs on canine tracheal mucociliary transport. Ann Otol Rhinol Laryngol. 1978 Jul-Aug;87(4 Pt 1):484–490. doi: 10.1177/000348947808700405. [DOI] [PubMed] [Google Scholar]
  9. Hurst G. A., Shaw P. B., LeMaistre C. A. Laboratory and clinical evaluation of the mucolytic properties of acetylcysteine. Am Rev Respir Dis. 1967 Nov;96(5):962–970. doi: 10.1164/arrd.1967.96.5.962. [DOI] [PubMed] [Google Scholar]
  10. Jepsen S., Klaerke A., Nielsen P. H., Nielsen S. T., Simonsen O. Systemic administration of N-acetylcysteine has no effect on postoperative lung function following elective upper laparotomy in lung healthy patients. Acta Anaesthesiol Scand. 1989 Apr;33(3):219–222. doi: 10.1111/j.1399-6576.1989.tb02894.x. [DOI] [PubMed] [Google Scholar]
  11. LAWSON D., SAGGERS B. A. N.A.C. AND ANTIBIOTICS IN CYSTIC FIBROSIS. Br Med J. 1965 Jan 30;1(5430):317–317. doi: 10.1136/bmj.1.5430.317. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Medici T. C., Chodosh S. Die Abwehrleistungen des Respirationstraktes. Schweiz Med Wochenschr. 1975 Aug 2;105(31):965–970. [PubMed] [Google Scholar]
  13. Millar A. B., Pavia D., Agnew J. E., Lopez-Vidriero M. T., Lauque D., Clarke S. W. Effect of oral N-acetylcysteine on mucus clearance. Br J Dis Chest. 1985 Jul;79(3):262–266. [PubMed] [Google Scholar]
  14. Olsson B., Johansson M., Gabrielsson J., Bolme P. Pharmacokinetics and bioavailability of reduced and oxidized N-acetylcysteine. Eur J Clin Pharmacol. 1988;34(1):77–82. doi: 10.1007/BF01061422. [DOI] [PubMed] [Google Scholar]
  15. REAS H. W. The effect of N-acetylcysteine on the viscosity of tracheobronchial secretions in cystic fibrosis of the pancreas. J Pediatr. 1963 Jan;62:31–35. doi: 10.1016/s0022-3476(63)80067-0. [DOI] [PubMed] [Google Scholar]
  16. SHEFFNER A. L., MEDLER E. M., JACOBS L. W., SARETT H. P. THE IN VITRO REDUCTION IN VISCOSITY OF HUMAN TRACHEOBRONCHIAL SECRETIONS BY ACETYLCYSTEINE. Am Rev Respir Dis. 1964 Nov;90:721–729. doi: 10.1164/arrd.1964.90.5.721. [DOI] [PubMed] [Google Scholar]
  17. Steventon R. D., Wilson R. S. Facemask or mouthpiece for delivery of nebulized bronchodilator aerosols? Br J Dis Chest. 1981 Jan;75(1):88–90. doi: 10.1016/s0007-0971(81)80012-5. [DOI] [PubMed] [Google Scholar]
  18. Sutton P. P., Gemmell H. G., Innes N., Davidson J., Smith F. W., Legge J. S., Friend J. A. Use of nebulised saline and nebulised terbutaline as an adjunct to chest physiotherapy. Thorax. 1988 Jan;43(1):57–60. doi: 10.1136/thx.43.1.57. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Sutton P. P., Lopez-Vidriero M. T., Pavia D., Newman S. P., Clay M. M., Webber B., Parker R. A., Clarke S. W. Assessment of percussion, vibratory-shaking and breathing exercises in chest physiotherapy. Eur J Respir Dis. 1985 Feb;66(2):147–152. [PubMed] [Google Scholar]
  20. Thomas P. A., Lynch R. E., Merrigan E. H. Prevention of postoperative pulmonary atelectasis: review of 215 cases and evaluation of acetycysteine. Am Surg. 1966 May;32(5):301–307. [PubMed] [Google Scholar]
  21. Todisco T., Polidori R., Rossi F., Iannacci L., Bruni B., Fedeli L., Palumbo R. Effect of N-acetylcysteine in subjects with slow pulmonary mucociliary clearance. Eur J Respir Dis Suppl. 1985;139:136–141. [PubMed] [Google Scholar]
  22. WEBB W. R. Clinical evaluaton of a new mucolytic agent, acetyl-cysteine. J Thorac Cardiovasc Surg. 1962 Sep;44:330–343. [PubMed] [Google Scholar]

Articles from Thorax are provided here courtesy of BMJ Publishing Group

RESOURCES