Evaluation of nebulized N-acetyl cysteine in outcome of esophageal atresia with tracheoesophegeal fistula
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Read the article on jpedsurg.org ↗Article · May 2020 · 1 min read
In brief
In brief
Non-randomized study of 60 EA+TEF patients demonstrates that nebulized N-acetyl cysteine significantly reduces airway secretion viscosity compared to saline controls, with treated patients showing earlier hospital discharge. While mortality rates were similar between groups, NAC nebulization appears safe and may improve postoperative outcomes, warranting further investigation through randomized trials.
Written by the GCMD Library team from the article.
Abstract
Aim
To evaluate the role of nebulized N-acetyl cysteine (NAC) in liquefying the airway secretions and improving the outcome of patients of esophageal atresia with tracheoesophageal fistula (EA + TEF).
Methods
It was a non-randomized interventional study. Two milliliters of 10% NAC was given in a nebulized form (2:5 dilution, every six hourly) to patients of ET + TEF, along with regular suction of upper esophageal pouch. The group was compared with control, which comprised patients of EA + TEF receiving only saline nebulization. The consistency of the secretions was compared by hand held consistometer in unit of time (seconds) required to cross a predetermined distance along with gravity.
Results
Sixty patients were assessed. Of these, 30 patients were present in both groups. The study group showed significant (p = 0.01–0.0001) decrease in consistency of secretions from the control group after day 2 of NAC nebulization. Patients' discharge was significantly (p = 0.01) earlier in cases. There was no significant (p = 0.41) difference in mortality between the groups. No specific adverse effects were observed in the study group.
Conclusion
It appears that nebulized NAC decreases the consistency of secretions in EA + TEF patients. It is interesting to note that the group of patients that received NAC was discharged earlier than the control group and had a higher survival rate than the control group. Whether this is directly attributable to the use of NAC is unknown. A prospective double-blinded randomized clinical trial is warranted to confirm these results.
Level of evidence
Level II, prospective comparative study (non-randomized).