Early administration of mucoactive agents and ventilator-free days: A propensity score-matched study

Background: Mucoactive agents are often prescribed for the management of airway secretions. However, it is unclear whether they improve respiratory outcomes in mechanically ventilated patients. Methods: We examined the association between the early administration of mucoactive agents in ventilated patients and increased ventilator-free days (VFDs). This retrospective observational study was conducted in two intensive care units (ICUs) of a tertiary care hospital in Japan. We applied 1:1 propensity score matching between the early mucoactive agent group and the on-demand mucoactive agent group. We compared VFDs during the first 28 days of ICU stay as the primary outcome between the groups. Results: In total, 662 participants were eligible for this study, and 94 participants (47 in each group) were included in the analysis. There was no difference in the median VFDs between the groups [21 days; interquartile (IQR) 1-24 for the early group vs. 20 days; IQR 13-24 for the on-demand group; P=0.53]. The median ICU-free days were 19 (range, 12-22) days and 19 (range, 13-22) days for the early and on-demand mucoactive agent groups, respectively (P=0.72). Conclusions: Early administration of mucoactive agents was not associated with increased VFDs.