Nonpharmacologic airway clearance techniques in hospitalized patients: A systematic review

Respiratory Care

Volumn 58, Issue 12, 2013, Pages 2160-2186

  Andrews, Jeff ^a   Sathe, Nila A ^a   Krishnaswami, Shanthi ^a   Melissa, L ^a  

^a VANDERBILT UNIVERSITY MEDICAL CENTER   (United States)

Author keywords

Airway clearance techniques; Airway obstruction therapy; Breathing exercises; Chest physical therapy; Physical therapy modalities

Indexed keywords

ANTIBIOTIC AGENT; BETA 2 ADRENERGIC RECEPTOR STIMULATING AGENT; CARBON MONOXIDE; CORTICOSTEROID; HEPARIN; IPRATROPIUM BROMIDE; METHYLPREDNISOLONE; OXYGEN; SALBUTAMOL; TERBUTALINE; THEOPHYLLINE;

ABDOMINAL SURGERY; ACTIVE CYCLE OF BREATHING TECHNIQUE; ACUTE LUNG INJURY; ARTERIAL CARBON DIOXIDE TENSION; ARTERIAL OXYGEN TENSION; ARTIFICIAL VENTILATION; ASTHMA; ASTHMATIC STATE; ATELECTASIS; BLOOD PH; BLOOD PRESSURE; BREATHING EXERCISE; BRONCHIECTASIS; BRONCHITIS; BRONCHOSPASM; CHRONIC OBSTRUCTIVE LUNG DISEASE; CORONARY ARTERY BYPASS SURGERY; COUGHING; CYSTIC FIBROSIS; DETERIORATION; DISEASE EXACERBATION; DRY THROAT; DYSPNEA; EVIDENCE BASED MEDICINE; EXPIRATORY CHEST WALL VIBRATION; EXPIRATORY FLOW; FACE MASK; FATIGUE; FLUTTER VALVE; FORCED VITAL CAPACITY; FUNCTIONAL RESIDUAL CAPACITY; HEART ARRHYTHMIA; HEART RATE; HEART VALVE SURGERY; HEMATOMA; HOSPITAL INFECTION; HOSPITAL PATIENT; HOSPITAL READMISSION; HOSPITALIZATION; HUMAN; HYPERINFLATION; INCENTIVE SPIROMETRY; INSPIRATORY CAPACITY; INTENSIVE CARE; INTERMETHOD COMPARISON; INTRAPULMONARY PERCUSSIVE VENTILATION; ISCHEMIC HEART DISEASE; LENGTH OF STAY; LUNG CLEARANCE; LUNG COMPLIANCE; LUNG COMPLICATION; META ANALYSIS; MOBILIZATION; MORTALITY; MUSCLE TRAINING; NAUSEA; NEBULIZATION; NONINVASIVE VENTILATION; OXYGEN SATURATION; OXYGEN THERAPY; PAIN; PATIENT ATTITUDE; PNEUMATIC CHEST PERCUSSOR; PNEUMONIA; POSITIVE END EXPIRATORY PRESSURE; POSTOPERATIVE COMPLICATION; POSTURAL DRAINAGE; PROPHYLAXIS; QUALITY OF LIFE; RELAXATION TRAINING; RESPIRATORY CARE; RESPIRATORY THERAPEUTIC DEVICE; REVIEW; RIB CAGE COMPRESSION; SEPSIS; SILICOSIS; SPIROMETRY; SPUTUM CLEARANCE TECHNIQUE; SYSTEMATIC REVIEW; TACHYCARDIA; TIDAL VOLUME; TRACHEOBRONCHIAL TOILET; TRACHEOSTOMY; TREATMENT DURATION; VENTILATOR ASSOCIATED PNEUMONIA;

AIRWAY CLEARANCE TECHNIQUES; AIRWAY OBSTRUCTION/THERAPY; BREATHING EXERCISES; CHEST PHYSICAL THERAPY; PHYSICAL THERAPY MODALITIES;

AIRWAY MANAGEMENT; BREATHING EXERCISES; COMPARATIVE EFFECTIVENESS RESEARCH; CRITICAL CARE; HOSPITALIZATION; HUMANS; MUCOCILIARY CLEARANCE; OUTCOME AND PROCESS ASSESSMENT (HEALTH CARE); PHYSICAL THERAPY MODALITIES; POSTOPERATIVE CARE; RESPIRATORY SYSTEM; RESPIRATORY THERAPY; RESPIRATORY TRACT DISEASES;

EID: 84888090903     PISSN: 00201324     EISSN: 19433654     Source Type: Journal    
DOI: 10.4187/respcare.02704     Document Type: Review

References (50)

1. Laurent GJ, Shapiro SD. Encyclopedia of respiratory medicine. Amsterdam: Elsevier 2006:332-343.
2. Reid WD, Brown JA, Konnyu KJ, Rurak JM, Sakakibara BM. Physiotherapy secretion removal techniques in people with spinal cord injury: a systematic review. J Spinal Cord Med 2010;33(4):353-370.
3. McCool FD, Rosen MJ. Nonpharmacologic airway clearance therapies: ACCP evidence-based clinical practice guidelines. Chest 2006; 129(1 Suppl):250S-259S.
4. Main E. What is the best airway clearance technique in cystic fibrosis? Paediatr Respir Rev 2013;14(Suppl 1):10-12.
5. Pisi G, Chetta A. Airway clearance therapy in cystic fibrosis patients. Acta Biomed 2009;80(2):102-106.
6. Bradley JM, Moran FM, Elborn JS. Evidence for physical therapies (airway clearance and physical training) in cystic fibrosis: an overview of five Cochrane systematic reviews. Respir Med 2006;100(2): 191-201.
7. Jones AP, Rowe BH. Bronchopulmonary hygiene physical therapy for chronic obstructive pulmonary disease and bronchiectasis. Cochrane Database Syst Rev 2000;(2):CD000045.
8. Schechter MS. Airway clearance applications in infants and children. Respir Care 2007;52(10):1382-1390, discussion 1390-1391.
9. Bruurs ML, van der Giessen LJ, Moed H. The effectiveness of physiotherapy in patients with asthma: a systematic review of the literature. Respir Med 2013;107(4):483-494.
10. Jones A, Rowe BH. Bronchopulmonary hygiene physical therapy in bronchiectasis and chronic obstructive pulmonary disease: a systematic review. Heart Lung 2000;29(2):125-135.
11. Hill K, Patman S, Brooks D. Effect of airway clearance techniques in patients experiencing an acute exacerbation of chronic obstructive pulmonary disease: a systematic review. Chron Respir Dis 2010; 7(1):9-17.
12. Osadnik CR, McDonald CF, Jones AP, Holland AE. Airway clearance techniques for chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2012;3:3.
13. Flume PA, Robinson KA, O'Sullivan BP, Finder JD, Vender RL, Willey-Courand DB, et al. Cystic fibrosis pulmonary guidelines: airway clearance therapies. Respir Care 2009;54(4):522-537.
14. Mahajan AK, Diette GB, Hatipoglu U, Bilderback A, Ridge A, Harris VW, et al. High frequency chest wall oscillation for asthma and chronic obstructive pulmonary disease exacerbations: a randomized sham-controlled clinical trial. Respir Res 2011;12:120.
15. Cross J, Elender F, Barton G, Clark A, Shepstone L, Blyth A, et al. A randomised controlled equivalence trial to determine the effectiveness and cost-utility of manual chest physiotherapy techniques in the management of exacerbations of chronic obstructive pulmonary disease (MATREX). Health Technol Assess 2010;14(23):1-147, iiiiv.
16. Kodric M, Garuti G, Colomban M, Russi B, Porta RD, Lusuardi M, et al. The effectiveness of a bronchial drainage technique (ELTGOL) in COPD exacerbations. Respirology 2009;14(3):424-428.
17. Haeffener MP, Ferreira GM, Barreto SS, Arena R, Dall'Ago P. Incentive spirometry with expiratory positive airway pressure reduces pulmonary complications, improves pulmonary function and 6-minute walk distance in patients undergoing coronary artery bypass graft surgery. Am Heart J 2008;156(5):900, e901-e908.
18. Clini EM, Antoni FD, Vitacca M, Crisafulli E, Paneroni M, Chezzi-Silva S, et al. Intrapulmonary percussive ventilation in tracheostomized patients: a randomized controlled trial. Intensive Care Med 2006;32(12):1994-2001.
19. DiDario AG, Whelan MA, Hwan WH, Yousef E, Cox TJ, Oldham HM, et al. Efficacy of chest physiotherapy in pediatric patients with acute asthma exacerbations. Pediatr Asthma Allergy Immunol 2009; 22(2):69-74.
20. Paludo C, Zhang L, Lincho CS, Lemos DV, Real GG, Bergamin JA. Chest physical therapy for children hospitalised with acute pneumonia: a randomised controlled trial. Thorax 2008;63(9):791-794.
21. Templeton M, Palazzo MG. Chest physiotherapy prolongs duration of ventilation in the critically ill ventilated for more than 48 hours. Intensive Care Med 2007;33(11):1938-1945.
22. Chen YC, Wu LF, Mu PF, Lin LH, Chou SS, Shie HG. Using chest vibration nursing intervention to improve expectoration of airway secretions and prevent lung collapse in ventilated ICU patients: a randomized controlled trial. J Chin Med Assoc 2009;72(6):316-322.
23. Ntoumenopoulos G, Presneill JJ, McElholum M, Cade JF. Chest physiotherapy for the prevention of ventilator-associated pneumonia. Intensive Care Med 2002;28(7):850-856.
24. Asher MI, Douglas C, Airy M, Andrews D, Trenholme A. Effects of chest physical therapy on lung function in children recovering from acute severe asthma. Pediatr Pulmonol 1990;9(3):146-151.
25. Syed N, Maiya AG, Siva Kumar T. Active Cycles of Breathing Technique (ACBT) versus conventional chest physical therapy on airway clearance in bronchiectasis: a crossover trial. Adv Physiother 2009;11(4):193-198.
26. Paneroni M, Clini E, Simonelli C, Bianchi L, Degli Antoni F, Vitacca M. Safety and efficacy of short-term intrapulmonary percussive ventilation in patients with bronchiectasis. Respir Care 2011; 56(7):984-988.
27. Antonaglia V, Lucangelo U, Zin WA, Peratoner A, De Simoni L, Capitanio G, et al. Intrapulmonary percussive ventilation improves the outcome of patients with acute exacerbation of chronic obstructive pulmonary disease using a helmet. Crit Care Med 2006;34(12): 2940-2945.
28. Chicayban LM, Zin WA, Guimaraes FS. Can the Flutter valve improve respiratory mechanics and sputum production in mechanically ventilated patients? A randomized crossover trial. Heart Lung 2011; 40(6):545-553.
29. Tsang SM, Jones AY. Postural drainage or Flutter device in conjunction with breathing and coughing compared to breathing and coughing alone in improving secretion removal and lung function in patients with acute exacerbation of bronchiectasis: a pilot study. H K Physiother J 2003;21:29-36.
30. Samransamruajkit R, Chin TW, Yuengsrigul A, Newton T, Nussbaum E. Possible beneficial effect of chest physical therapy in hospitalized asthmatic children. Pediatr Asthma Allergy Immunol 2003; 16(4):295-303.
31. Bellone A, Spagnolatti L, Massobrio M, Bellei E, Vinciguerra R, Barbieri A, et al. Short-term effects of expiration under positive pressure in patients with acute exacerbation of chronic obstructive pulmonary disease and mild acidosis requiring non-invasive positive pressure ventilation. Intensive Care Med 2002;28(5):581-585.
32. Ambrosino N, Callegari G, Galloni C, Brega S, Pinna G. Clinical evaluation of oscillating positive expiratory pressure for enhancing expectoration in diseases other than cystic fibrosis. Monaldi Arch Chest Dis 1995;50(4):269-275.
33. Unoki T, Kawasaki Y, Mizutani T, Fujino Y, Yanagisawa Y, Ishimatsu S, et al. Effects of expiratory rib-cage compression on oxygenation, ventilation, and airway-secretion removal in patients receiving mechanical ventilation. Respir Care 2005;50(11):1430-1437.
34. Berney S, Denehy L. A comparison of the effects of manual and ventilator hyperinflation on static lung compliance and sputum production in intubated and ventilated intensive care patients. Physiother Res Int 2002;7(2):100-108.
35. Ntoumenopoulos G, Gild A, Cooper DJ. The effect of manual lung hyperinflation and postural drainage on pulmonary complications in mechanically ventilated trauma patients. Anaesth Intensive Care 1998; 26(5):492-496.
36. Krause MW, Van Aswegen H, De Wet EH, Joubert G. Postural drainage in intubated patients with acute lobar atelectasis: a pilot study. S African J Physiother 2000;56(3):29-32.
37. Barker M, Adams S. An evaluation of a single chest physiotherapy treatment on mechanically ventilated patients with acute lung injury. Physiother Res Int 2002;7(3):157-169.
38. Vargas F, Bui HN, Boyer A, Salmi LR, Gbikpi-Benissan G, Guenard H, et al. Intrapulmonary percussive ventilation in acute exacerbations of COPD patients with mild respiratory acidosis: a randomized controlled trial. Crit Care 2005;9(4):R382-R389.
39. Mackay MR, Ellis E, Johnston C. Randomised clinical trial of physiotherapy after open abdominal surgery in high risk patients. Aust J Physiother 2005;51(3):151-159.
40. Denehy L, Carroll S, Ntoumenopoulos G, Jenkins S. A randomized controlled trial comparing periodic mask CPAP with physiotherapy after abdominal surgery. Physiother Res Int 2001;6(4):236-250.
41. de Charmoy SB, Eales CJ. The role of prophylactic chest physiotherapy after cardiac valvular surgery: is there one? S African J Physiother 2000;56(3):24-28.
42. Fagevik Olsén M, Hahn I, Nordgren S, Lonroth H, Lundholm K. Randomized controlled trial of prophylactic chest physiotherapy in major abdominal surgery. Br J Surg 1997;84(11):1535-1538.
43. Johnson D, Kelm C, Thomson D, Burbridge B, Mayers I. The effect of physical therapy on respiratory complications following cardiac valve surgery. Chest 1996;109(3):638-644.
44. Johnson D, Kelm C, To T, Hurst T, Naik C, Gulka I, et al. Postoperative physical therapy after coronary artery bypass surgery. Am J Respir Crit Care Med 1995;152(3):953-958.
45. Naraparaju S, Vaishali K, Venkatesan P, Acharya V. A comparison of the Acapella and a threshold inspiratory muscle trainer for sputum clearance in bronchiectasis: a pilot study. Physiother Theory Pract 2010;26(6):353-357.
46. Pellegrino R, Viegi G, Brusasco V, Crapo RO, Burgos F, Casaburi R, et al. Interpretative strategies for lung function tests. Eur Respir J 2005;26(5):948-968.
47. Marques A, Bruton A, Barney A. Clinically useful outcome measures for physiotherapy airway clearance techniques: a review. Phys Ther Rev 2006;11(4):299-307.
48. Hyatt RE, Scanlon PD, Nakamura M. Interpretation of pulmonary function tests: a practical guide. Philadelphia: Lippincott Williams & Wilkins; 2009.
49. Yang M, Yan Y, Yin X, Wang BY, Wu T, Liu GJ, et al. Chest physiotherapy for pneumonia in adults. Cochrane Database Syst Rev 2010;(2):2.
50. Ides K, Vissers D, De Backer L, Leemans G, De Backer W. Airway clearance in COPD: need for a breath of fresh air? A systematic review. COPD 2011;8(3):196-205.