01302nam a2200229   4500001000800000005001700008007000300025008004100028040000800069041000800077100003200085245005800117300002300175520061300198650003100811650003600842650002400878650002900902650001700931700002200948773010200970ESSALUD20260821150043.0ta      t        pe ||||| |||| 00| 0 spa d  aBMG  aeng  aLa Vita, Carolyn J. eAutor  aMucolytics in respiratory failure — A MARCH forward  apáginas: 817-818  aIn patients with acute respiratory failure, difficulty managing respiratory secretions may contribute to adverse outcomes. Airway mucus is a multilayered substance consisting of a viscoelastic glycoprotein gel, a liquid layer, and a thin layer of surfactant. Mucus is cleared from the airway primarily by the action of cilia (mucociliary clearance) and interaction with airflow (cough). In acute respiratory failure, airway irritation from relatively dry inhaled gasses, infection, and inflammation can lead to mucus hypersecretion, and sedation and neuromuscular impairment can contribute to impaired cough.  aMEDICINA CLÍNICA GENERAL  aMEDICINA CLÍNICA HOSPITALARIA  aCUIDADOS INTENSIVOS  aVENTILACIÓN MECÁNICA  aNEUMOLOGÍA  aHardin, C. Corey 0 022717dMassachusetts NEJM GroupoNEJM12tThe New England Journal of Medicine wESSALUDx0028-4793