Abstract
This review describes a framework for providing a personalised approach to selecting the
most appropriate airway clearance technique (ACT) for the individual patient. It is based on a
synthesis of the physiological evidence that supports the modulation of ventilation and
expiratory airflow as a means of assisting airway clearance. By possessing a strong
understanding of the physiological basis for ACTs, it will enable clinicians to decide which
ACT best aligns with the individual patient’s pathology in diseases with anatomical
bronchiectasis and mucus hyper-secretion.
The physiological underpinning of postural drainage is that by placing a patient in various
positions, gravity enhances mobilisation of secretions. Newer ACTs are based on two other
physiological premises: the ability to ventilate behind obstructed regions of the lung; and the
capacity to achieve the minimum expiratory airflow bias necessary to mobilise secretions.
After reviewing each ACT to determine if it utilises both ventilation and expiratory flow,
these physiological concepts are assessed against the clinical evidence to provide a
mechanism for the effectiveness of each ACT. This paper provides the clinical rationale
necessary to determine the most appropriate ACT for each patient, thereby improving care.
Original language | English |
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Journal | European Respiratory Review |
Volume | 26 |
Issue number | 143 |
DOIs | |
Publication status | Published - 21 Feb 2017 |
Keywords
- airway clearance
- chronic
- Lung Diseases