Year in Review 2014: Airway Clearance

Strickland, Shawna L

doi:10.4187/respcare.04095

Cited by 11 publications

(7 citation statements)

References 14 publications

(14 reference statements)

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“…In human medicine, the elimination of airway secretions is of great importance in the treatment of respiratory diseases or diseases that predispose to their appearance, such as cystic fibrosis (Hoo et al, 2015). Although there are still controversies about the best techniques for each situation (Strickland, 2015), the action of eliminating secretions assumes even greater importance in hospitalized and/ or bedridden people, who have difficulty in eliminating secretions (Wang et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

“…These techniques can be active and performed by the person (postural drainage, forced expiration techniques, positive expiratory pressure with or without oscillation, etc.) or passive, with external manipulation (manual thoracic percussions and vibrocompression), percussive non-invasive ventilation, and, more recently, with the use of chest vibration devices (Hoo et al, 2015;Reychler et al, 2018;Strickland, 2015).…”

Section: Introductionmentioning

confidence: 99%

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Adaptation and acceptability testing of the Expector® vibration vest in horses

Oliveira

Silva

Zibordi

et al. 2022

Braz. J. Vet. Res. Anim. Sci.

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The project is based on a test of a thoracic vibration vest prototype, adapted to equines by the Expector® vest’s company, on healthy animals. Ten (10) equines were used in the project, male or female, adults, healthy, belonging to FMVZUSP or private owners. Each animal went through two phases: A and B. Phase A consisted of the placement of the vest without turning on the vibrators, evaluating the animal’s acceptability, facility, adaptation to the animal’s body, and discomfort due to the vest’s use. Phase B included the placement of the vest and turning on the vibrators, evaluating the animal’s acceptability, reaction to the vibrators, and, if present, to which velocity/type of vibration, and the presence of adverse effects. Both phases were done three times on separate days. The behavioral parameters: “placement facility” and “adaptation to the animal’s body” were observed. In phase B, the response to the vibration was classified from 0 to 5. The answer was evaluated on low and high intensities for the four vibration types. The heart rate (HR) and respiratory rate (RR) were also evaluated at the beginning and end of each repetition. The animals’ HR was kept on normal, except for one animal on one day of the test. Concerning the RR, most animals presented moments of tachypnea. On the experiment’s first day, 100% of grade Great to “facility of placement” and “adaptation to the animal’s body” was obtained, but on days 2 and 3 this value dropped to 90% due to alterations in one animal’s responses. Regarding vibration’s responses, 77.3% were evaluated as no discomfort (grade 0), 17.1% little discomfort (grade 1), 3.3% medium discomfort (grade 2), 0.4% great discomfort (grade 3), 0.21% extreme discomfort (grade 4), and 1.6% non-acceptance of the vest (grade 5). Some possible changes on the prototype were also verified to be suggested to the manufacturer, such as the change of the buckle and the use of wireless control. Vest use appears promising for equine respiratory physiotherapy, considering the acceptability was good, and its efficiency on the expectoration of diseased animals must be tested.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Adaptation and acceptability testing of the Expector® vibration vest in horses

Oliveira

Silva

Zibordi

et al. 2022

Braz. J. Vet. Res. Anim. Sci.

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“…Several bronchial hygiene techniques use the mechanical ventilator as a tool, with the advantage of monitoring pressures, flows and volumes during the application of the techniques (Strickland, 2015). Manual hyperinflation (MHI) or mechanical ventilator (VHI) are alternatives in bronchial hygiene therapy (França et al., 2012).…”

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

Ventilator versus manual hyperinflation in adults receiving mechanical ventilation: A systematic review

Valer¹,

Bonczynski²,

Scheffer³

et al. 2022

Physiotherapy Res Intl

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Introduction Manual hyperinflation (MHI) or with a mechanical ventilator (VHI) are alternatives in bronchial hygiene therapy, in recent years several studies have emerged with the objective of verifying the effectiveness and safety of the techniques. Objective Systematically review and analyze the most recent studies in the literature on MHI and VHI, compare both techniques and demonstrate their effectiveness in bronchial hygiene therapy in mechanically ventilated patients. Methods We conducted this systematic review based on the PICO strategy and used the databases Ovid, LILACS, CINAHL, Pubmed and CENTRAL. Search, selection and analysis of randomized controlled trials on MHI, VHI or comparing both techniques. We performed a comparison on secretion elimination, static and dynamic compliance, oxygenation and clinical outcomes. The studies were analyzed by two independent evaluators. Results Nine articles were selected comparing MHI with usual care, demonstrating improved compliance in the MHI group, but with no impact on secretion removal. Four studies compared VHI with usual care, with three showing increased secretion elimination and compliance in the HVM group. Another four articles compared MHI with VHI but none of the studies showed superiority in terms of elimination of secretion and three studies found improvement in static compliance. Conclusion Both techniques have proven to be effective alternatives to bronchial hygiene therapy.

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“…The availability of MI-E devices in Europe since 2002 has increased the number of studies initiated. 25,26 The first team that performed a systematic review on MI-E was Anderson et al 27 in 2005. Their systematic review included 4 controlled trials, with a total of 98 subjects with neuromuscular disease.…”

Section: Introductionmentioning

confidence: 99%

Use of Mechanical Insufflation-Exsufflation Devices for Airway Clearance in Subjects With Neuromuscular Disease

Auger¹,

Hernando²,

Galmiche³

2017

Respir Care

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The aim of this systematic review is to examine the benefit/risk ratio of the use of mechanical insufflation-exsufflation (MI-E) devices for airway clearance in patients with neuromuscular diseases. A search was conducted for relevant studies in MEDLINE, the Cochrane Library, and the Health Technology Assessment Database using the main key words: cough, airway clearance, in-exsufflation. The search limits were studies published in English and French between 1970 and 2014 (literature watch until December 2015). The methodological quality of the studies was assessed using (1) the Cochrane Collaboration's risk of bias tool for randomized controlled trials and (2) the Institute of Health Economics' 20-item checklist for comparative and observational studies. Data were extracted into an evidence table according to (1) study design, (2) population characteristics (including age and type of diseases) and intervention (MI-E associated or not with other interventions), (3) outcome measures, and (4) key findings. Twelve studies met the inclusion criteria (4 randomized controlled trials, 3 comparative studies, and 5 observational studies). The quality of the selected studies was poor. None of the studies reported survival outcome. All studies evaluated change of pulmonary function parameters, such as peak expiratory flow. This review underlines the lack of robust data on mechanical medical devices used for airway clearance. The current scientific evidence does not support the use of MI-E for cough augmentation in patients with neuromuscular diseases, but health-care professionals are faced with the reality of medical practice and the absence of alternatives. Most European and American guidelines recommend the use of MI-E despite low-level evidence. However, even if performing comparative trials in a specific population is difficult, the medical device industry should provide reliable data to assist health-care professionals, providers, and payers in the decision-making process. This is the only way to ensure the best treatment for patients.

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Year in Review 2014: Airway Clearance

Cited by 11 publications

References 14 publications

Adaptation and acceptability testing of the Expector® vibration vest in horses

Adaptation and acceptability testing of the Expector® vibration vest in horses

Ventilator versus manual hyperinflation in adults receiving mechanical ventilation: A systematic review

Use of Mechanical Insufflation-Exsufflation Devices for Airway Clearance in Subjects With Neuromuscular Disease

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