Paper - WANFANG MED ONLINE

You Position: Home > Paper

Consensus of Chinese experts on the clinical application of nebulized expectorants

( views:939, downloads:5716 )

Author:: No author available

Journal Title:: Chinese Journal of Tuberculosis and Respiratory Diseases

Issue:: 4

DOI:: 10.3760/cma.j.cn112147-20200623-00742

Key Word:: No keyword available

Abstract：痰液潴留、咳痰困难是临床最为常见的呼吸系统症状之一，不仅降低患者生活质量，更可能影响临床预后。常用祛痰治疗包括物理祛痰及药物祛痰，后者的给药途径包括口服、静脉和雾化吸入；其中，雾化吸入祛痰总体上安全、快速、有效，适用于伴有痰液黏稠、咳痰困难的慢性阻塞性肺疾病、急慢性支气管炎、支气管哮喘、支气管扩张症、肺炎、肺脓肿以及围手术期等多种疾病。本共识对常用雾化装置及雾化祛痰药物的使用方式和注意事项进行了归纳，并详细阐述了不同疾病患者雾化祛痰指征、治疗方法和注意事项。

Reference

[1]曲东,任晓旭,郭琳瑛,等.雾化吸入N-乙酰半胱氨酸对气管导管内生物被膜致呼吸机相关肺炎的影响[J].2016,(4).
[2]朱春梅,曹玲,王菲.儿童塑型性支气管炎[J].2013,(3).
[3]中华医学会呼吸病学分会呼吸治疗学组.机械通气时雾化吸入专家共识（草案）[J].2014,(11).
[4]代丽,曹鑫.乙酰半胱氨酸雾化治疗肺炎支原体肺炎合并肺不张的疗效观察[J].2016,(5).
[5]汪宏苗,唐冬,李刚.N-乙酰半胱氨酸雾化吸入治疗老年AECOPD患者的临床观察[J].2017,(8).
[6]慢性气道炎症性疾病气道黏液高分泌管理中国专家共识编.慢性气道炎症性疾病气道黏液高分泌管理中国专家共识[J].2015,(10).
[7]李红艳,翁恒,王琳,等.岩盐气溶胶疗法治疗支气管哮喘患者的临床疗效及机制研究[J].2013,(6).
[8]中华医学会呼吸病学分会《雾化吸入疗法在呼吸疾病中的应用专家共识》制定专家组.雾化吸入疗法在呼吸疾病中的应用专家共识[J].2016,(34).
[9]中华医学会临床药学分会《雾化吸入疗法合理用药专家共识》编写组.雾化吸入疗法合理用药专家共识（2019年版）[J].2019,(2).
[10]姜丽霞.小儿雾化室控制医院感染的措施[J].2011,(9).
[11].Nebulized Drug Admixtures: Effect on Aerosol Characteristics and Albuterol Output[J].2006.
[12]Goswami M,Jawali N.N-acetylcysteine-mediated modulation of bacterial antibiotic susceptibility.[J].2010,54(8).
[13]Anh L. Innes,Prescott G. Woodruff,Ronald E. Ferrando,etc.Epithelial Mucin Stores Are Increased in the Large Airways of Smokers With Airflow Obstruction[J].2006,130(4).
[14]Polverino, Eva,Goeminne, Pieter C.,McDonnell, Melissa J.,etc.European Respiratory Society guidelines for the management of adult bronchiectasis[J].2017,50(3).
[15]Dinicola, S.,De Grazia, S.,Pintucci, J. P.,etc.N-acetylcysteine as powerful molecule to destroy bacterial biofilms. A systematic review[J].2014,18(19).
[16]Burchett DK,Darko W,Zahra J,etc.Mixing and compatibility guide for commonly used aerosolized medications.[J].2010,67(3).
[17]Chen, Rui,Hu, Bin,Liu, Ying,etc.Beyond PM2.5: The role of ultrafine particles on adverse health effects of air pollution[J].2016,1860(12).
[18]Seyed Masoom, Masoompour,Amir, Anushiravani,Amir, Tafaroj Norouz.Evaluation of the Effect of Nebulized N-Acetylcysteine on Respiratory Secretions in Mechanically Ventilated Patients: Randomized Clinical Trial.[J].2015,40.
[19]Bonasia, Philip J.,McVicar, William K.,Williams, Bill,etc.Chemical and Physical Compatibility of Levalbuterol Inhalation Solution Concentrate Mixed With Budesonide, Ipratropium Bromide, Cromolyn Sodium, or Acetylcysteine Sodium[J].2008,53(12).
[20]Megan C.L. Smith,Elizabeth R. Ellis.Is retained mucus a risk factor for the development of postoperative atelectasis and pneumonia? -- Implications for the physiotherapist[J].2000,16(2).
[21]Kumar, Animesh,Jat, Kana Ram,Srinivas, M.,etc.Nebulized N-Acetylcysteine for Management of Plastic Bronchitis[J].2018,55(8).
[22]Kim, Ki-Hyun,Kabir, Ehsanul,Kabir, Shamin.A review on the human health impact of airborne particulate matter[J].2015,74(Jan.).
[23]Lingmei, Huang,Jinding, Pu,Fang, He,etc.Positive feedback of the amphiregulin-EGFR-ERK pathway mediates PM2.5 from wood smoke-induced MUC5AC expression in epithelial cells.[J].2017,7(1).
[24]Bruce K, Rubin.Physiology of airway mucus clearance.[J].2002,47(7).
[25]W R, WEBB.New Mucolytic Agents for Sputum Liquefaction.[J].1964,36.
[26]Jian,Wang,Mengchan,Zhu,Linlin,Wang,etc.Amphiregulin potentiates airway inflammation and mucus hypersecretion induced by urban particulate matter via the EGFR-PI3Kα-AKT/ERK pathway.[J].2018,53.
[27]Marcia S, Volpe,Alexander B, Adams,Marcelo B P, Amato,etc.Ventilation patterns influence airway secretion movement.[J].2008,53(10).
[28]多学科围手术期气道管理中国专家共识(2018版)专家组.多学科围手术期气道管理中国专家共识（2018版）[J].2018,(7).
[29]P Lange,J Nyboe,M Appleyard,etc.Relation of ventilatory impairment and of chronic mucus hypersecretion to mortality from obstructive lung disease and from all causes.[J].1990,45(8).
[30]Eliasson V,Riise GC,Qvarfordt I,etc.Inhibitory effect of N-acetylcysteine on adherence of Streptococcus pneumoniae and Haemophilus influenzae to human oropharyngeal epithelial cells in vitro.[J].2000,67(5).
[31]卫生部合理用药专家委员会.中国医师药师临床用药指南（第2版）[M].2014.
[32]Stockley,R.,Whitters,D..Immunity and bacterial colonisation in bronchiectasis[J].2012,67(11).
[33]杨宝峰，陈建国.药理学（第9版）[M].2018.
[34]Kennedy, Daniel,Gelder, Colin,Church, Alistair Colin,etc.BTS/ICS guideline for the ventilatory management of acute hypercapnic respiratory failure in adults[J].2016,71(Suppl.2).
[35].U.S. Labor Department's MSHA makes New Emergency Mine Evacuation Rules[J].2007,40(3).
[36]Mandell, Lionel A.,Niederman, Michael S..Aspiration Pneumonia[J].2019,380(7).
[37]George,Ntoumenopoulos.Do commonly used ventilator settings for mechanically ventilated adults have the potential to embed secretions or promote clearance?[J].2011,56.
[38]Avdeev, S. N.,Truschenko, N., V,Gaynitdinova, V. V.,etc.Treatment of exacerbations of chronic obstructive pulmonary disease[J].2018,90(12).
[39]R, Balsamo,L, Lanata,C G, Egan.Mucoactive drugs.[J].2010,19(116).
[40]Maggie, McIlwaine,Judy, Bradley,J Stuart, Elborn,etc.Personalising airway clearance in chronic lung disease.[J].2017,26(143).
[41]Michael F. Papacostas,Peter Luckett,Susan Hupp.The use of pulmonary clearance medications in the acutely ill patient[J].2017,11(10).
[42]Jiang, Jingjin,Wang, Yuehong,Tang, Xiaoping,etc.Regulation of Viral Infection-induced Airway Remodeling Cytokine Production by the TLR3-EGFR Signaling Pathway in Human Bronchial Epithelial Cells[J].2016,13(6).
[43]Zea, Borok,A S, Verkman.Lung edema clearance: 20 years of progress: invited review: role of aquaporin water channels in fluid transport in lung and airways.[J].2002,93(6).
[44]Yongchun, Shen,Shaoguang, Huang,Jian, Kang,etc.Management of airway mucus hypersecretion in chronic airway inflammatory disease: Chinese expert consensus (English edition).[J].2018,13(Spec ).
[45]Richard D, Branson.Secretion management in the mechanically ventilated patient.[J].2007,52(10).
[46]Fahy JV,Dickey BF.Airway mucus function and dysfunction.[J].2010,363(23).
[47]Tiemei, Zhao,Youning, Liu.N-acetylcysteine inhibit biofilms produced by Pseudomonas aeruginosa.[J].2010,10.
[48]Kate M,Johnson,Abdollah,Safari,Wan C,Tan,etc.Heterogeneity in the respiratory symptoms of patients with mild-to-moderate COPD.[J].2018,13.
[49]Kamin,W.,Erdnüss,F.,Kr?mer,I..Inhalation solutions - which ones may be mixed? Physico-chemical compatibility of drug solutions in nebulizers - update 2013[J].2014,13(3).
[50]D, Olivieri,S A, Marsico,M, Del Donno.Improvement of mucociliary transport in smokers by mucolytics.[J].1985,139.
[51]Blasi, Francesco,Page, Clive,Rossolini, Gian Maria,etc.The effect of N-acetylcysteine on biofilms: Implications for the treatment of respiratory tract infections[J].2016,117.
[52]Qian,Qi,Yirepanjaing,Ailiyaer,Ruijuan,Liu,etc.Effect of N-acetylcysteine on exacerbations of bronchiectasis (BENE): a randomized controlled trial.[J].2019,20(1).
[53]M F, Parry,H C, Neu.Effect of N-acetylcysteine on antibiotic activity and bacterial growth in vitro.[J].1977,5(1).
[54]J, Iravani,G N, Melville,G, Horstmann.N-Acetylcysteine and mucociliary activity in mammalian airways.[J].1978,28(2).
[55]Laura M Kuyper,Peter D Paré,James C Hogg,etc.Characterization of airway plugging in fatal asthma[J].2003,115(1).
[56]G C, Mereto,L, Balestra,F, Henriquet.Alveolar surfactant in lungs of operated patients after acetylcysteine treatment.[J].1980,111.
[57]J, Vestbo,E, Prescott,P, Lange.Association of chronic mucus hypersecretion with FEV1 decline and chronic obstructive pulmonary disease morbidity. Copenhagen City Heart Study Group.[J].1996,153(5).
[58]倪忠,罗凤鸣,王吉梅,等.针对新型冠状病毒肺炎患者的雾化吸入治疗的建议[J].2020,(2).
[59]M. Del Donno,D. Bittesnich,A. Chetta,etc.The Effect of Inflammation on Mucociliary Clearance in Asthma: An Overview[J].2000,118(4).
[60]Piccin VS,Caldini EG,Negri EM,etc.Effects of different mechanical ventilation strategies on the mucociliary system.[J].2011,37(1).
[61]P.S. Richardson,R.J. Phipps.The anatomy, physiology, pharmacology and pathology of tracheobronchial mucus secretion and the use of expectorant drugs in human disease[J].1978,3(4).
[62]J C, Joseph.Compatibility of nebulizer solution admixtures.[J].1997,31(4).
[63]C, Pérez-Giraldo,A, Rodríguez-Benito,F J, Morán,etc.Influence of N-acetylcysteine on the formation of biofilm by Staphylococcus epidermidis.[J].1997,39(5).
[64]Adriana Pereira,Bruce P Krieger.Pulmonary complications of pregnancy[J].2004,25(2).
[65]C B, Wilson,P W, Jones,C J, O'Leary,etc.Effect of sputum bacteriology on the quality of life of patients with bronchiectasis.[J].1997,10(8).
[66]Kashef, Nasim,Karami, Shima,Djavid, Gholamreza Esmaeeli.Phototoxic effect of hypericin alone and in combination with acetylcysteine on Staphylococcus aureus biofilms[J].2015,12(2).
[67]F.Konrad,R.Schiener,T.Marx,etc.Ultrastructure and mucociliary transport of bronchial respiratory epithelium in intubated patients[J].1995,21(6).
[68]Burgel PR,Nesme-Meyer P,Chanez P,etc.Cough and sputum production are associated with frequent exacerbations and hospitalizations in COPD subjects.[J].2009,135(4).
[69].Causes of secretion retention: Patient factors, ventilation, devices, drugs[J].2014,10(3).
[70]McManus K,Bonde P,McGuigan J,etc.Lung surgery: identifying the subgroup at risk for sputum retention.[J].2002,22(1).
[71]Gregory B. Diette,Peter White Jr.,Peter Terry,etc.Quality Assessment Through Patient Self-report of Symptoms Prefiberoptic and Postfiberoptic Bronchoscopy[J].1998,114(5).