How to manage respiratory secretions? My patient got re-intubated because of lots of secretions. It was a difficult extubation after 18 days of mechanical ventilation. I have to re-intubate him after 5 days of extubation because of lots of secretions. Glycopyrrolate and NAC is going on round the clock.

Initially it showed response, hence extubated but again secretions increased. He is a bed-ridden, mentally challenged 18 years old male. Help is much appreciated.