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Contact the study team using the details below to take part. If there are no contact details below please ask your doctor in the first instance.
Dr
Bronwen
Connolly
+44 (0)28 9097 2215
b.connolly@qub.ac.uk
Dr
Caroline
Wilson
+44 (0)28 961 51447
MARCH@nictu.hscni.net
More information about this study, what is involved and how to take part can be found on the study website.
Acute respiratory failure
This information is provided directly by researchers, and we recognise that it isn't always easy to understand. We are working with researchers to improve the accessibility of this information. In some summaries, you may come across links to external websites. These websites will have more information to help you better understand the study.
When patients are critically ill, one of the main complications is called acute respiratory failure. This is when a patient’s illness causes their lungs to fail to work (lung failure). Patients need to be admitted to the Intensive Care Unit (ICU) and often need to have a breathing machine, or ventilator, to help them breathe and ensure that enough oxygen gets into their blood.
However, one problem that can occur as a result of being on a ventilator is difficulty clearing secretions (mucus, or sputum) from the lungs. Not being able to clear secretions from the lungs can make breathing harder, and this may result in developing a lung infection (called ventilator-associated pneumonia).
To reduce the problem of thick secretions, the air coming from the ventilator can have moisture added to it (humidification). Other treatments can include using a suction tube to remove secretions via the breathing tube. Physiotherapists may also use techniques to help clear secretions.
In some cases, medications called ‘mucoactives’ may be prescribed for patients. Mucoactives are medications that work to help clear secretions from the airways. Two examples of mucoactives are carbocisteine and hypertonic saline. Carbocisteine can help by changing the thickness and stickiness of secretions, which may help clear mucus from the lungs. It is given to patients in the ICU whilst they are on a breathing machine in either liquid form or as a powder dissolved in water, through the patient’s feeding tube. Hypertonic saline is salty water that is delivered into the airways via a device called a nebuliser, which turns the salty water into a mist. The mist may stimulate coughing to help clear thick secretions from the lungs.
Carbocisteine and hypertonic saline are commonly given to patients with long-term respiratory conditions such as bronchiectasis or cystic fibrosis, as they have been shown to be helpful. The researchers carried out a survey of UK ICUs and found that about a third of patients on a breathing machine (ventilator) with lung failure were receiving a mucoactive, and carbocisteine and hypertonic saline were the most commonly used. However, it is not known for certain if these medications work in patients admitted to the ICU with lung failure.
The aim of this study is to investigate whether using one, or both, of these mucoactives (carbocisteine and hypertonic saline) really helps patients when they have difficulty clearing secretions, and if as a result, this means patients spend less time on the breathing machine (ventilator). The researchers will also determine whether these mucoactives can improve other important outcomes for patients during their ICU stay, such as being taken off the breathing machine (ventilator) and having the breathing tube removed (extubation), the need to have the breathing tube put back in (reintubation), and how long patients stayed in the ICU and in hospital. The researchers will record whether patients experience any side effects from the use of these mucoactives.
Start dates may differ between countries and research sites. The research team are responsible for keeping the information up-to-date.
The recruitment start and end dates are as follows:
You can take part if:
You may not be able to take part if:
1. Pre-existing chronic respiratory condition receiving routine use of any mucoactive2. Mucoactive treatment started more than 24 hours prior to trial enrolment3. Known adverse reaction to either study mucoactive4. Treatment withdrawal expected within 24 hours5. Known pregnancy6. Previous enrolment in the MARCH trial7. Declined consent8. Prisoners9. The treating physician believes that participation in the trial would not be in the best interests of the patient
Below are the locations for where you can take part in the trial. Please note that not all sites may be open.
Dr
Caroline
Wilson
+44 (0)28 961 51447
MARCH@nictu.hscni.net
Dr
Bronwen
Connolly
+44 (0)28 9097 2215
b.connolly@qub.ac.uk
More information about this study, what is involved and how to take part can be found on the study website.
The study is sponsored by Belfast Health and Social Care Trust and funded by Health Technology Assessment Programme.
Your feedback is important to us. It will help us improve the quality of the study information on this site. Please answer both questions.
Or CPMS 51165
You can print or share the study information with your GP/healthcare provider or contact the research team directly.
