Meta‐analysis of high doses of ambroxol treatment for acute lung injury/acute respiratory distress syndrome based on randomized controlled trials

This study seeks to evaluate the potential benefits of high doses of ambroxol treatment for acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) by conducting a meta‐analysis based on randomized controlled trials (RCTs). We searched the Pubmed, Embase, China National Knowledge Infrastructure, and Wanfang databases through December 2013. Only RCTs evaluating high doses of ambroxol (≥15 mg/kg or 1000 mg/day) treatment for patients with ALI/ARDS were selected. We included 10 RCTs involving 508 patients. Adjuvant treatment with high doses of ambroxol increased PaO 2 /FiO 2 (weight mean differences [WMD] = 69.18, 95% confidence intervals [CI]: 41.71–96.65), PO 2 (WMD = 11.74, 95% CI: 8.50–14.99), and SaO 2 (WMD = 2.15, 95% CI: 1.60–2.71) compared with usual treatment. Treatment with high doses of ambroxol appeared to reduce serum tumor necrosis factor‐α level (WMD −7.92 µg/L; 95% CI, −10.94 to −4.9) and interleukin‐6 level (WMD = −20.65 µg/L, 95% CI: −24.74 to −16.55) and to increase serum superoxide dismutase level (WMD = 19.07 NU/mL, 95% CI: 6.16–31.97). The findings suggest that treatment with high doses of ambroxol appears to improve PaO 2 /FiO 2 , PO 2 , and SaO 2 , and the benefits might be related to ambroxol's anti‐oxidant and anti‐inflammatory properties.