MARCH trial (Mucoactives in Acute Respiratory failure: Carbocisteine and Hypertonic saline)
Mucoactive drugs for acute respiratory failure: A 2x2 factorial, randomised, controlled, open-label, Phase 3, pragmatic, clinical and cost effectiveness trial with internal pilot
Principal Investigator: Prof. Anil Hormis
'Many patients in intensive care (ICU) need help to breathe from a breathing machine (ventilator). However, one problem that can occur as a result of being on a ventilator, is difficulty clearing secretions (mucus) from the lungs. ...To reduce the problem of thick secretions, the air coming from the ventilator can have moisture added to it (humidification). Other treatments can include using a suction tube to remove secretions via the breathing tube. Physiotherapists may also use techniques to help clear thick secretions. In some cases medications called mucoactive drugs may be prescribed. Two common mucoactive drugs used in ICUs in the UK are 'hypertonic saline' and 'carbocisteine'. We conducted a survey of UK ICUs and found that about one-third of patients on a ventilator will be receiving a mucoactive drug. However, we do not know if these mucoactive drugs really help patients with thick secretions or not. In our trial we want to know if using one, or both, of these mucoactive drugs helps with clearing thick secretions, and if as a result, this means patients spend less time on the ventilator. We also want to know how safe they are, and if they can improve other important outcomes during the ICU stay'.