MARCH
MARCH is an NIHR Study that seeks to examine the most clinically effective therapy for patients who require mucolytics. it specifically compares the efficacy of carbocisteine with hypertonic saline.
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Patients are randomised to
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Carbocisteine (enterally)
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Hypertonic saline delivered by airway nebulisation
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Combination of Carbocisteine AND hypertonic saline
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Usual airway clearance management ALONE (includes suctioning, heated humidification, respiratory physiotherapy)
INCLUSION CRITERIA
1. Age >16
2. An acute and potentially reversible cause of Acute Respiratory Failure as determined by the treating physician
3. Receiving invasive mechanical ventilation via endotracheal tube or tracheostomy
4. Anticipated to remain on invasive mechanical ventilation for at least 48 hours
5. Presence of secretions that are difficult to clear with usual airway clearance management (as assessed by the treating clinical team)
EXCLUSION CRITERIA
1. Pre-existing chronic respiratory condition receiving routine use of any muco-active
2. Muco-active treatment started more than 24 hours prior to trial enrolment
3. Known adverse reaction to either study muco-active
4. Treatment withdrawal expected within 24 hours
5. Known pregnancy - Please complete a pregnancy test for all women between 15-55 years
6. Previous enrolment in the MARCH trial
7. Declined consent
8. The treating physician believes that participation in the trial would not be in the best interests of the patient
Study Information
MARCH trial is generally well embedded in King's Critical Care.
