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Mechanism of action of mucoactive drugs in critically ill patients with acute respiratory failure

Project Description

Acute respiratory failure (ARF) accounts for the majority of patient admissions to the intensive care unit (ICU). Nearly all patients require invasive mechanical ventilation. However one major risk of mechanical ventilation is respiratory tract secretion retention due to secretion thickness and impaired mucociliary clearance, leading to infection, irreversible damage to lung tissue, and reduced pulmonary function.

Mucoactive drugs are one treatment option for management of secretions. Examples include nebulised/inhaled hypertonic saline and systemic carbocisteine. These two drugs have distinct mechanisms of action which may confer differing benefits to secretion clearance. Hypertonic saline is an expectorant mucoactive drug, defined as one which elicits expulsion of mucus from the respiratory tract, typically via a cough mechanism. Carbocisteine, an antioxidant, is a mucoregulatory drug that regulates mucus secretion through restoring the viscoelastic properties of mucus and an anti-inflammatory effect.

This study will investigate whether the mechanism of action of hypertonic saline and/or carbocisteine in the treatment of critically ill patients with ARF is due to a decrease in sputum viscoelasticity, inflammation, and bacterial load. Sputum samples collected from patients receiving one, or either, or both, of these drugs will be evaluated for sputum elasticity, sputum viscosity as well as IL-6, IL-8 and 8-isoprostane and changes in bacterial abundance and composition.


Candidates should have or expect to obtain a 2:1 or higher Honours degree or equivalent in a relevant biomedical or life sciences subject.

English Language

Candidates applying from countries where the first language is not English should produce evidence of their competence through a qualification such as IELTS or TOEFL score.

The minimum recommended score for the School of Medicine, Dentistry and Biomedical Science is:
• IELTS score of 6.0 with not less than 5.5 in each of the four component elements of listening, reading, speaking and writing taken within the last 2 years;
• TOEFL score of 80+ (internet basted test), taken within the last 2 years, with minimum component scores of; Listening 17, Reading 18, Speaking 20, Writing 17);
• A valid Certificate of Proficiency in English grade A or B;
• A valid Certificate of Advanced English grade A; or
• A first or upper second class honours degree from a university based in the UK, Republic of Ireland or other suitably quality assured location in a country deemed by the UK Border Agency to be majority English speaking.

For a list of English Language qualifications also accepted by the School and University please see the following link:

INTO Queen’s English Language Courses offers both pre-sessional and in-sessional courses in English for academic purposes and study skills. Courses vary in length and full information can be obtained at:

Funding Notes

*FUNDING CONFIRMED – Department for the Economy (DfE) Award*

Eligibility for both fees (£4,327 for 2019/20, 2020/21 TBC) and maintenance (£15,009 for 2019/20, 2020/21 TBC) depends on the applicants being either an ordinary UK resident or those EU residents who have lived permanently in the UK for the 3 years immediately preceding the start of the studentship.

Non UK residents who hold EU residency may also apply but if successful may receive fees only.

For further details re eligibility criteria (including academic, citizenship and residency criteria) please click on the following link: View Website


Please visit the School of Medicine, Dentistry and Biomedical Sciences, Centre for Experimental Medicine, website for further details about the Centre:

When applying, please choose 'MEDICINE' as your subject area/School.

Related Subjects

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