Preventing mucus plugging in invasively ventilated intensive care unit patients—routine or personalized care and ‘primum non nocere’

We thank Dr. Rello for his comments on the results of the ‘Preventive Nebulization of Mucolytic Agents and Bronchodilating Drugs in Intubated and Ventilated Intensive Care Unit Patients (NEBULAE)’ study (1), a randomized clinical trial in invasively ventilated critically ill patients that compared routine with on-demand nebulization of acetylcysteine with salbutamol with respect to duration of ventilation (2).