From the Research
Hardening of secretions in pneumonia can be effectively managed with nebulized N-acetylcysteine, as evidenced by a recent case report 1, which highlights its life-saving potential in critically ill patients. To address this issue, the following interventions can be considered:
- Adequate hydration, with patients drinking 2-3 liters of water daily unless contraindicated by other medical conditions
- Mucolytic medications like N-acetylcysteine (NAC) at 600mg twice daily or guaifenesin (400mg every 4 hours) to help break down thick secretions
- Nebulized treatments with 3-5ml of 0.9% saline solution or hypertonic saline (3-7%) 2-4 times daily to loosen hardened mucus
- Chest physiotherapy, including postural drainage and percussion techniques performed 2-3 times daily for 15-20 minutes, to mobilize secretions
- Using a humidifier in the patient's room to maintain airway moisture, while deep breathing exercises (10 deep breaths every hour while awake) promote secretion clearance These interventions work by increasing the water content of mucus, breaking disulfide bonds in mucus proteins, and enhancing ciliary function to move secretions upward for expectoration, ultimately improving airway clearance and supporting recovery from pneumonia. A recent study 2 also supports the use of nebulized acetylcysteine inhalation combined with bronchoscopy in treating elderly patients with severe ventilator-associated pneumonia, showing significant improvements in respiratory mechanics and blood gas analysis indicators. However, it's essential to note that the effectiveness of these interventions may vary depending on the individual patient's condition and the underlying cause of pneumonia, as highlighted in a recent review 3.