MARCH Participant Information

Mucoactive medications (hereafter ‘mucoactives’) are sometimes prescribed to clear thick secretions. ‘Carbocisteine’ and ‘Hypertonic saline’ are two mucoactives commonly used in UK ICUs. One-third of patients on ventilators receive a mucoactive. However, we do not know if these mucoatives help patients with thick secretions.

Our study will investigate whether one, or both mucoactives clear thick secretions and if their use reduces the time patients spend on ventilators. We will look at patient safety, and any differences in patients’ ICU stay. We will follow patients up for 6 months to know their quality of life and treatment costs to the NHS. We will record if patients die. We will share our study results with ICU clinicians, patients and key decision-makers to improve patient care in the future.

The study will recruit 1956 patients from at least 40 ICUs across the UK. Patients on a ventilator for at least 2 days with thick secretions will be allocated to one of four groups by chance.

Group 1: Carbocisteine plus Usual airway clearance management (suctioning, heated humidification, and respiratory physiotherapy)
Group 2: Hypertonic Saline plus Usual airway clearance management
Group 3: Carbocisteine and hypertonic saline plus Usual airway clearance management
Group 4: Usual airway clearance management

A large experienced team of health care professionals and researchers lead this study, including former patients and family members. They will ensure the trial runs smoothly, safely, and finishes on time.