Mucociliary clearance is impaired in acutely ill patients.
OBJECTIVE
This study aimed to investigate nasal mucociliary clearance in acutely ill patients who were clinically stable and had no airway manipulation.


METHODS
Prospective clinical study.


METHODS
Medical ICU.


METHODS
Sixteen medical patients admitted to the ICU and 16 healthy subjects were studied. Patients who were receiving airway manipulation, including tracheal suctioning, nasogastric or enteral tubes, noninvasive and invasive mechanical ventilation, were excluded.


METHODS
Mucociliary clearance was evaluated by saccharine transit time (STT) measurements at ICU admission (admission) and 90 days after hospital discharge (recovery). Healthy subjects were also subjected to two measurements 90 days apart.


RESULTS
The STT of patients was 26.4 +/- 11.3 min and 17.9 +/- 8.6 min at admission and recovery (p = 0.002) [mean +/- SD] but did not change along the 90-day interval in healthy subjects (17.2 +/- 10.2 min and 16.7 +/- 10.3 min), respectively. Smokers (patients and healthy subjects) presented prolonged STT when compared to nonsmokers (p = 0.026). STT at admission correlated positively with heart rate (r = 0.560; p = 0.024) and hospital stay (r = 0.634; p = 0.008).


CONCLUSIONS
Mucociliary clearance is impaired in stable acutely ill patients with no airway manipulation and correlates with simple markers of underlying disease severity. Mucociliary dysfunction may help to explain the increased susceptibility of hospital-acquired respiratory infection in critically ill patients.
Nakagawa
Naomi Kondo
NK
University of São Paulo City UNICID, São Paulo, Brazil. naomikondo@uol.com.br
Franchini
Michelle Lisidati
ML
Driusso
Patrícia
P
de Oliveira
Luciana Rabello
LR
Saldiva
Paulo Hilário Nascimento
PH
Lorenzi-Filho
Geraldo
G
D000328:Adult; D000368:Aged; D016638:Critical Illness; D005260:Female; D005772:Gastrointestinal Transit; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009079:Mucociliary Clearance / Q000502:physiology*; D010102:Oxygen Inhalation Therapy; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000503:physiopathology*; D012439:Saccharin / Q000493:pharmacokinetics; D012907:Smoking
D012439:Saccharin