title: Meta-analysis of high doses of ambroxol treatment for acute lung injury/acute respiratory distress syndrome based on randomized controlled trials.
abstract: This study seeks to evaluate the potential benefits of high doses of ambroxol treatment for acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) by conducting a meta-analysis based on randomized controlled trials (RCTs). We searched the Pubmed, Embase, China National Knowledge Infrastructure, and Wanfang databases through December 2013. Only RCTs evaluating high doses of ambroxol (≥15 mg/kg or 1000 mg/day) treatment for patients with ALI/ARDS were selected. We included 10 RCTs involving 508 patients. Adjuvant treatment with high doses of ambroxol increased PaO(2)/FiO(2) (weight mean differences [WMD] = 69.18, 95% confidence intervals [CI]: 41.71-96.65), PO(2) (WMD = 11.74, 95% CI: 8.50-14.99), and SaO(2) (WMD = 2.15, 95% CI: 1.60-2.71) compared with usual treatment. Treatment with high doses of ambroxol appeared to reduce serum tumor necrosis factor-α level (WMD -7.92 µg/L; 95% CI, -10.94 to -4.9) and interleukin-6 level (WMD = -20.65 µg/L, 95% CI: -24.74 to -16.55) and to increase serum superoxide dismutase level (WMD = 19.07 NU/mL, 95% CI: 6.16-31.97). The findings suggest that treatment with high doses of ambroxol appears to improve PaO(2)/FiO(2), PO(2), and SaO(2), and the benefits might be related to ambroxol's anti-oxidant and anti-inflammatory properties.
authors.affiliation: Department of Critical Care Medicine, Institute of Critical Care Medicine, The First Hospital Affiliated to Dalian Medical University, Dalian, China.
authors.forename: Xiangdong
authors.initials: X
authors.lastname: Wu
authors.forename: Suwei
authors.initials: S
authors.lastname: Li
authors.forename: Jiuzhi
authors.initials: J
authors.lastname: Zhang
authors.forename: Yongli
authors.initials: Y
authors.lastname: Zhang
authors.forename: Lili
authors.initials: L
authors.lastname: Han
authors.forename: Qiuming
authors.initials: Q
authors.lastname: Deng
authors.forename: Xianyao
authors.initials: X
authors.lastname: Wan
mesh_terms: D000551:Ambroxol / Q000008:administration & dosage* / Q000627:therapeutic use*; D015415:Biomarkers; D016207:Cytokines / Q000235:genetics / Q000378:metabolism; D005100:Expectorants / Q000008:administration & dosage / Q000627:therapeutic use; D005786:Gene Expression Regulation / Q000187:drug effects; D006801:Humans; D055370:Lung Injury / Q000188:drug therapy*; D018384:Oxidative Stress; D010100:Oxygen / Q000097:blood; D016032:Randomized Controlled Trials as Topic; D012128:Respiratory Distress Syndrome / Q000188:drug therapy*
chemical_list: D015415:Biomarkers; D016207:Cytokines; D005100:Expectorants; D000551:Ambroxol; D010100:Oxygen
keywords: acute lung injury; acute respiratory distress syndrome; ambroxol; meta-analysis