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Cited by 101Nosocomial Infections in ICURespiratory Support and MechanismsIntensive Care Unit Cognitive Disorders

Mucociliary clearance is impaired in acutely ill patients

Nakagawa, Naomi Kondo, Franchini, Michelle Lisidati, Driusso, Patrícia, de Oliveira, Luciana Rabello, Saldiva, Paulo Hilário Nascimento, Lorenzi-Filho, Geraldo·2005·Chest
DOI 10.1378/chest.128.4.2772
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Abstract

Objective This study aimed to investigate nasal mucociliary clearance in acutely ill patients who were clinically stable and had no airway manipulation.Design Prospective clinical study.Setting Medical ICU.Patients and participants 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.Interventions 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.Measurements and 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).Conclusion 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.

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  • Depressed consciousness and sedation blunt the cough reflex, and endotracheal intubation and acute illness impair the mucociliary escalator.

    “Depressed consciousness and sedation blunt the cough reflex,46 and endotracheal intubation and acute illness impair the mucociliary escalator.”

    From The microbiome and critical illness (2016) · cites this paper as [47]

  • In alveolar injury, the bactericidal surfactant layer is inactivated and microbial elimination is slowed by impairment of mucociliary clearance.

    “The bactericidal surfactant layer is inactivated55,57 and microbial elimination is slowed by impairment of mucociliary clearance.”

    From The microbiome and critical illness (2016) · cites this paper as [47]

  • The virulence of pathogens familiar in intensive care is promoted by conditions of nutrient scarcity, competition from neighbouring community members, disruption of stabilising commensal relationships, and exposure to the mediators of the host stress response.

    “The virulence of pathogens familiar in intensive care is promoted by conditions of nutrient scarcity, competition from neighbouring community members, disruption of stabilising commensal relationships,20 and exposure to the mediators of the host stress response”

    From The microbiome and critical illness (2016) · cites this paper as [47]

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Authors
Nakagawa, N. K., Franchini, M. L., Driusso, P., de Oliveira, L. R., Saldiva, P. H. N., & Lorenzi-Filho, G.
Affiliations
Universidade de São Paulo (BR)
Corresponding author
Nakagawa, Naomi Kondo
ORCID
Venue
Chest
Publisher
Elsevier BV
Published
2005-10
Volume
128
Issue
4
Pages
2772-2777
ISSN
0012-3692 (ISSN-L)
DOI
10.1378/chest.128.4.2772
OpenAlex
W2148873756
Cited by
101
References
30
Citations by year
2026: 4 · 2025: 6 · 2024: 2 · 2023: 8 · 2022: 5 · 2021: 4 · 2020: 8 · 2019: 6 · 2018: 6 · 2017: 4 · 2016: 5 · 2015: 8 · 2014: 6 · 2013: 2 · 2012: 7
FWCI
1.82
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • CHEST Journal (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Nosocomial Infections in ICU
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
  • Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
Keywords
mucociliary clearance, acute illness, critically ill patients, medical ICU, smoking, heart rate, length of hospital stay, disease severity
MeSH terms
Adult, Aged, Female, Gastrointestinal Transit, Humans, Intensive Care Units, Male, Middle Aged, Mucociliary Clearance, Oxygen Inhalation Therapy, Prospective Studies, Respiratory Tract Infections, Saccharin, Smoking, Critical Illness

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