SynthesisThorax2020
Mucoactive agents for acute respiratory failure in the critically ill: a systematic review and meta-analysis.
Synthesis in Thorax, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06834581 (Effects of Vibrating Mesh Nebulisation in Patients on Long-term Tracheostomy Ventilation), which is not on this map. Cited by 11 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Effects of Vibrating Mesh Nebulisation in Patients on Long-term Tracheostomy Ventilation: a Pilot Randomised Crossover Trial
Who cites it
11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 18 citations in OpenAlex.
- Research without prior consent procedure and intervention effect on mortality in critical care: a meta-epidemiological study of randomized controlled trials.Critical care (London, England) · 2025Pooled it
- Use of mechanical insufflation exsufflation and manual techniques in an intubated adult with COVID-19 positioned in prone-A case study.Physiotherapy research international : the journal for researchers and clinicians in physical therapy · 2022Pooled it
- Optimizing aerosol therapy in mechanically ventilated acute respiratory distress syndrome: a delivery-fidelity framework.Frontiers in medicine · 2026Review
- Association between early administration of mucoactive agents and in-hospital mortality in patients with pneumonia requiring mechanical ventilation: a nationwide cohort study.Journal of intensive care · 2025Article
- Red blood cell distribution width and mortality in chronic obstructive pulmonary disease patients with acute respiratory failure: a retrospective study.Scientific reports · 2025Article
- Physiology and pathophysiology of mucus and mucolytic use in critically ill patients.Critical care (London, England) · 2025Review
- Article
- Early-Onset Ventilator-Associated Pneumonia in Pediatric Severe Traumatic Brain Injury.Neurocritical care · 2023Article
- Early administration of mucoactive agents and ventilator-free days: a propensity score-matched study.Annals of translational medicine · 2023Article
- Expert group recommendation on inhaled mucoactive drugs in pediatric respiratory diseases: an Indian perspective.Frontiers in pediatrics · 2023Review
- Mucus Clearance Strategies in Mechanically Ventilated Patients.Frontiers in physiology · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors at 7 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeAcute respiratory failure (ARF) is a common cause of admission to intensive care units (ICUs). Mucoactive agents are medications that promote mucus clearance and are frequently administered in patients with ARF, despite a lack of evidence to underpin clinical decision making. The aim of this systematic review was to determine if the use of mucoactive agents in patients with ARF improves clinical outcomes.
methodsWe searched electronic and grey literature (January 2020). Two reviewers independently screened, selected, extracted data and quality assessed studies. We included trials of adults receiving ventilatory support for ARF and involving at least one mucoactive agent compared with placebo or standard care. Outcomes included duration of mechanical ventilation. Meta-analysis was undertaken using random-effects modelling and certainty of the evidence was assessed using Grades of Recommendation, Assessment, Development and Evaluation.
resultsThirteen randomised controlled trials were included (1712 patients), investigating four different mucoactive agents. Mucoactive agents showed no effect on duration of mechanical ventilation (seven trials, mean difference (MD) -1.34, 95% CI -2.97 to 0.29, I
conclusionOur findings do not support the use of mucoactive agents in critically ill patients with ARF. The existing evidence is of low quality. High-quality randomised controlled trials are needed to determine the role of specific mucoactive agents in critically ill patients with ARF. PROSPERO REGISTRATION NUMBER: CRD42018095408.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.