Meeting ReportConference Proceedings

Pediatric Airway Maintenance and Clearance in the Acute Care Setting: How To Stay Out of Trouble

Brian K Walsh, Kristen Hood and Greg Merritt
Respiratory Care September 2011, 56 (9) 1424-1444; DOI: https://doi.org/10.4187/respcare.01323

References

  1. 1.↵
    1. Hess DR
    . Airway clearance: physiology, pharmacology, techniques, and practice. Respir Care 2007;52(10):1392–1396.
    OpenUrlAbstract/FREE Full Text
  2. 2.↵
    1. Gaskell D,
    2. Webber BA
    . The Brompton Hospital guide to chest physiotherapy. Oxford: Blackwell Scientific; 1973.
  3. 3.↵
    1. Hough A
    . Physiotherapy in respiratory care: a problem solving approach. London: Chapman & Hall; 1991.
  4. 4.↵
    1. Mellins R
    . Pulmonary physiotherapy in the pediatric age group. Am Rev Respir Dis 1974;110(2):137–142.
    OpenUrlPubMedWeb of Science
  5. 5.↵
    1. Faling L
    . Chest physical therapy. Philadelphia: Lippincott; 1991:625–654.
  6. 6.↵
    1. Sutton P
    . Assessment of percussion, vibratory shaking, and breathing exercises in chest physiotherapy. Eur J Respir Dis 1985;66(2):147–152.
    OpenUrlPubMedWeb of Science
  7. 7.↵
    1. Sutton P
    . Assessment of the forced expiratory technique, postural drainage and directed cough in chest physiotherapy. Eur J Respir Dis 1983;64(1):62–68.
    OpenUrlPubMedWeb of Science
  8. 8.↵
    1. Murphy MB CD,
    2. FitzGerald M
    . Chest percussion: help or hindrance to postural drainage. Int Med J 1983;76:189–190.
    OpenUrl
  9. 9.↵
    1. van der Schans C
    . Effect of manual percussion in tracheobronchial clearance in patients with chronic obstruction and excessive tracheobronchial secretion. Thorax 1986;41:448–452.
    OpenUrlAbstract/FREE Full Text
  10. 10.↵
    1. Rogers DF
    . Pulmonary mucus: pediatric perspective. Pediatr Pulmonol 2003;36(3):178–188.
    OpenUrlCrossRefPubMedWeb of Science
  11. 11.↵
    1. Jeffrey PK
    . The development of large and small airways. Am J Respir Crit Care Med 1998;157(5 Pt 2):S174–S180.
    OpenUrlCrossRefPubMedWeb of Science
  12. 12.↵
    1. Montuschi P
    . Indirect monitoring of lung inflammation. Nat Rev 2002;1(3):238–242.
    OpenUrl
  13. 13.↵
    1. Ricciardolo FL,
    2. Gaston B,
    3. Hunt J
    . Acid stress in the pathology of asthma. J Allergy Clin Immunol 2004;113(4):610–619.
    OpenUrlCrossRefPubMedWeb of Science
  14. 14.↵
    1. Paget-Brown AO,
    2. Hunt JF,
    3. Gaston B
    . Tracheal aspirate pH is alkaline in pre-term human infants. Eur Respir J 2007;30(5):840–842.
    OpenUrlAbstract/FREE Full Text
  15. 15.↵
    1. Hunt JF,
    2. Fang K,
    3. Malik R,
    4. Snyder A,
    5. Malhotra N,
    6. Platts-Mills TA,
    7. et al
    . Endogenous airway acidification. Implications for asthma pathophysiology. Am J Respir Crit Care Med 2000;161(3 Pt 1):694–699.
    OpenUrlCrossRefPubMedWeb of Science
  16. 16.
    1. Tate S,
    2. MacGregor G,
    3. Davis M,
    4. Innes JA,
    5. Greening AP
    . Airways in cystic fibrosis are acidified: detection by exhaled breath condensate. Thorax 2002;57(11):926–929.
    OpenUrlAbstract/FREE Full Text
  17. 17.↵
    1. Kostikas K,
    2. Papatheodorou G,
    3. Ganas K,
    4. Psathakis K,
    5. Panagou P,
    6. Loukides S
    . pH in expired breath condensate of patients with inflammatory airway diseases. Am J Respir Crit Care Med 2002;165(10):1364–1370.
    OpenUrlCrossRefPubMedWeb of Science
  18. 18.↵
    1. Gessner C,
    2. Hammerschmidt S,
    3. Kuhn H,
    4. Seyfarth HJ,
    5. Sack U,
    6. Engelmann L,
    7. et al
    . Exhaled breath condensate acidification in acute lung injury. Respir Med 2003;97(11):1188–1194.
    OpenUrlCrossRefPubMedWeb of Science
  19. 19.↵
    1. Gaston B,
    2. Hunt JF
    . How acidopneic is my patient? A new question in the pulmonary laboratory. Am J Respir Crit Care Med 2002;165(10):1349–1350.
    OpenUrlPubMed
  20. 20.↵
    1. Hunt J
    . Exhaled breath condensate: an evolving tool for noninvasive evaluation of lung disease. J Allergy Clin Immunol 2002;110(1):28–34.
    OpenUrlCrossRefPubMedWeb of Science
  21. 21.↵
    1. Pugin J,
    2. Dunn-Siegrist I,
    3. Dufour J,
    4. Tissieres P,
    5. Charles PE,
    6. Comte R
    . Cyclic stretch of human lung cells induces an acidification and promotes bacterial growth. Am J Respir Cell Mol Biol 2008;38(3):362–370.
    OpenUrlCrossRefPubMedWeb of Science
  22. 22.↵
    1. Gaston B
    . Expired nitric oxide in pediatric asthma: emissions testing for children? J Pediatr 1997;131(3):343–344.
    OpenUrlPubMedWeb of Science
  23. 23.↵
    1. Ricciardolo FLM,
    2. Rado V,
    3. Fabbri LM,
    4. Sterk PJ,
    5. Di Maria GU,
    6. Geppetti P
    . Bronchoconstriction induced by citric acid inhalation in guinea pigs: role of tachykinins, bradykinin, and nitric oxide. Am J Respir Crit Care Med 1999;159(2):557–562.
    OpenUrlCrossRefPubMedWeb of Science
  24. 24.
    1. Bevan S,
    2. Geppetti P
    . Protons: small stimulants of capsaicin-sensitive sensory nerves. Trends Neurosci 1994;17(12):509–512.
    OpenUrlCrossRefPubMedWeb of Science
  25. 25.
    1. Holma B,
    2. Lindegren M,
    3. Andersen JM
    . pH effects on ciliomotility and morphology of respiratory mucosa. Arch Environ Health 1977;32(5):216–226.
    OpenUrlPubMedWeb of Science
  26. 26.
    1. Low PM,
    2. Luk CK,
    3. Dulfano MJ,
    4. Finch PJ
    . Ciliary beat frequency of human respiratory tract by different sampling techniques. Am Rev Respir Dis 1984;130(3):497–498.
    OpenUrlPubMed
  27. 27.
    1. Holma B,
    2. Hegg PO
    . pH- and protein-dependent buffer capacity and viscosity of respiratory mucus. Their interrelationships and influence on health. Sci Total Environ 1989;84:71–82.
    OpenUrlCrossRefPubMed
  28. 28.
    1. Holma B
    . Effects of inhaled acids on airway mucus and its consequences for health. Environ Health Perspect 1989;79:109–113.
    OpenUrlCrossRefPubMed
  29. 29.
    1. Nakayama K,
    2. Jia YX,
    3. Hirai H,
    4. Shinkawa M,
    5. Yamaya M,
    6. Sekizawa K,
    7. Sasaki H
    . Acid stimulation reduces bactericidal activity of surface liquid in cultured human airway epithelial cells. Am J Respir Cell Mol Biol 2002;26(1):105–113.
    OpenUrlPubMedWeb of Science
  30. 30.
    1. Zelenina M,
    2. Bondar AA,
    3. Zelenin S,
    4. Aperia A
    . Nickel and extracellular acidification inhibit the water permeability of human aquaporin-3 in lung epithelial cells. J Biol Chem 2003;278(32):30037–30043.
    OpenUrlAbstract/FREE Full Text
  31. 31.↵
    1. Horvath G,
    2. Schmid N,
    3. Fragoso MA,
    4. Schmid A,
    5. Conner GE,
    6. Salathe M,
    7. et al
    . Epithelial organic cation transporters ensure pH-dependent drug absorption in the airway. Am J Respir Cell Mol Biol 2007;36(1):53–60.
    OpenUrlCrossRefPubMedWeb of Science
  32. 32.↵
    1. Luk CK,
    2. Dulfano MJ
    . Effect of pH, viscosity and ionic-strength changes on ciliary beating frequency of human bronchial explants. Clin Sci 1983;64(4):449–451.
    OpenUrlAbstract/FREE Full Text
  33. 33.↵
    1. Hammerschmidt S,
    2. Kuhn H,
    3. Grasenack T,
    4. Gessner C,
    5. Wirtz H
    . Apoptosis and necrosis induced by
  34. 34.↵
    1. Oberwaldner B
    . Physiotherapy for airway clearance in paediatrics. Eur Respir J 2000;15(1):196–204.
    OpenUrlAbstract/FREE Full Text
  35. 35.↵
    1. Papastamelos C,
    2. Panitch HB,
    3. England SE,
    4. Allen JL
    . Developmental changes in chest wall compliance in infancy and early childhood. J Appl Physiol 1995;78(1):179–184.
    OpenUrlAbstract/FREE Full Text
  36. 36.↵
    1. Lai-Fook SJ,
    2. Hyatt RE
    . Effects of age on elastic moduli of human lungs. J Appl Physiol 2000;89(1):163–168.
    OpenUrlAbstract/FREE Full Text
  37. 37.↵
    1. Penn RB,
    2. Wolfson MR,
    3. Shaffer TH
    . Developmental differences in tracheal cartilage mechanics. Pediatr Res 1989;26(5):429–433.
    OpenUrlPubMedWeb of Science
  38. 38.↵
    1. Hall GL,
    2. Hantos Z,
    3. Wildhaber JH,
    4. Sly PD
    . Contribution of nasal pathways to low frequency respiratory impedance in infants. Thorax 2002;57(5):396–399.
    OpenUrlAbstract/FREE Full Text
  39. 39.↵
    1. McKiernan C,
    2. Chua LC,
    3. Visintainer PF,
    4. Allen H
    . High flow nasal cannulae therapy in infants with bronchiolitis. J Pediatr 2010;156(4):634–638.
    OpenUrlCrossRefPubMedWeb of Science
  40. 40.↵
    United States Department of Labor, OSHA Directorate of Technical Support and Emergency Management. Anesthetic gases: guidelines for workplace exposures. July 20, 1999. Revised May 18, 2000. http://www.osha.gov/dts/osta/anestheticgases/index.html. Accessed July 12, 2011.
  41. 41.↵
    1. Skoog J
    . Relative air humidity in hospital wards - user perception and technical consequences. Indoor Build Environ 2006(15):93–97.
  42. 42.↵
    1. Chatburn RL,
    2. Lough MD,
    3. Klinger JD
    . An in-hospital evaluation of the sonic mist ultrasonic room humidifier. Respir Care 1984;29(9):893–899.
    OpenUrlPubMed
  43. 43.↵
    1. Zuravleff JJ,
    2. Yu VL,
    3. Shonnard JW,
    4. Rihs JD,
    5. Best M
    . Legionella pneumophila contamination of a hospital humidifier. Demonstration of aerosol transmission and subsequent subclinical infection in exposed guinea pigs. Am Rev Respir Dis 1983;128(4):657–661.
    OpenUrlPubMedWeb of Science
  44. 44.↵
    1. Naftali S,
    2. Schroter RC,
    3. Shiner RJ,
    4. Elad D
    . Transport phenomena in the human nasal cavity: a computational model. Ann Biomed Eng 1998;26(5):831–839.
    OpenUrlCrossRefPubMedWeb of Science
  45. 45.↵
    1. Williams R,
    2. Rankin N,
    3. Smith T,
    4. Galler D,
    5. Seakins P
    . Relationship between the humidity and temperature of inspired gas and the function of the airway mucosa. Crit Care Med 1996;24(11):1920–1929.
    OpenUrlCrossRefPubMedWeb of Science
  46. 46.↵
    1. Kilgour E,
    2. Rankin N,
    3. Ryan S,
    4. Pack R
    . Mucociliary function deteriorates in the clinical range of inspired air temperature and humidity. Intensive Care Med 2004;30(7):1491–1494.
    OpenUrlPubMedWeb of Science
  47. 47.↵
    1. Todd DA,
    2. Boyd J,
    3. Lloyd J,
    4. John E
    . Inspired gas humidity during mechanical ventilation: effects of humidification chamber, airway temperature probe position and environmental conditions. J Paediatr Child Health 2001;37(5):489–494.
    OpenUrlCrossRefPubMedWeb of Science
  48. 48.↵
    1. Solomita M,
    2. Palmer LB,
    3. Daroowalla F,
    4. Liu J,
    5. Miller D,
    6. LeBlanc DS,
    7. et al
    . Humidification and secretion volume in mechanically ventilated patients. Respir Care 2009;54(10):1329–1335.
    OpenUrlPubMed
  49. 49.↵
    1. Kelly M,
    2. Gillies D,
    3. Todd DA,
    4. Lockwood C
    . Heated humidification versus heat and moisture exchangers for ventilated adults and children. Cochrane Database Syst Rev 2010;(4):CD004711.
  50. 50.↵
    1. Argent AC
    . Endotracheal suctioning is basic intensive care or is it? Pediatr Res 2009;66(4):364–367.
    OpenUrlPubMed
  51. 51.↵
    1. Gardner DL,
    2. Shirland L
    . Evidence-based guideline for suctioning the intubated neonate and infant. Neonatal Netw 2009;28(5):281–302.
    OpenUrlPubMed
  52. 52.↵
    1. Kiraly NJ,
    2. Tingay DG,
    3. Mills JF,
    4. Morley CJ,
    5. Dargaville PA,
    6. Copnell B
    . The effects of closed endotracheal suction on ventilation during conventional and high-frequency oscillatory ventilation. Pediatr Res 2009;66(4):400–404.
    OpenUrlPubMed
  53. 53.↵
    1. Argent AC,
    2. Morrow BM
    . What does chest physiotherapy do to sick infants and children? Intensive Care Med 2004;30(6):1014–1016.
    OpenUrlPubMed
  54. 54.↵
    1. Hoellering AB,
    2. Copnell B,
    3. Dargaville PA,
    4. Mills JF,
    5. Morley CJ,
    6. Tingay DG
    . Lung volume and cardiorespiratory changes during open and closed endotracheal suction in ventilated newborn infants. Arch Dis Child Fetal Neonatal Ed 2008;93(6):F436–F441.
    OpenUrlAbstract/FREE Full Text
  55. 55.↵
    1. Kiraly NJ,
    2. Tingay DG,
    3. Mills JF,
    4. Dargaville PA,
    5. Copnell B
    . Volume not guaranteed: closed endotracheal suction compromises ventilation in volume-targeted mode. Neonatology 2011;99(1):78–82.
    OpenUrlPubMed
  56. 56.↵
    1. Copnell B,
    2. Dargaville PA,
    3. Ryan EM,
    4. Kiraly NJ,
    5. Chin LO,
    6. Mills JF,
    7. et al
    . The effect of suction method, catheter size, and suction pressure on lung volume changes during endotracheal suction in piglets. Pediatr Res 2009;66(4):405–410.
    OpenUrlCrossRefPubMed
  57. 57.↵
    1. Kalyn A,
    2. Blatz S,
    3. Sandra F,
    4. Paes B,
    5. Bautista C
    . Closed suctioning of intubated neonates maintains better physiologic stability: a randomized trial. J Perinatol 2003;23(3):218–222.
    OpenUrlCrossRefPubMed
  58. 58.↵
    1. van Veenendaal MB,
    2. Miedema M,
    3. de Jongh FH,
    4. van der Lee JH,
    5. Frerichs I,
    6. van Kaam AH
    . Effect of closed endotracheal suction in high-frequency ventilated premature infants measured with electrical impedance tomography. Intensive Care Med 2009;35(12):2130–2134.
    OpenUrlCrossRefPubMed
  59. 59.↵
    1. Seymour CW,
    2. Cross BJ,
    3. Cooke CR,
    4. Gallop RL,
    5. Fuchs BD
    . Physiologic impact of closed-system endotracheal suctioning in spontaneously breathing patients receiving mechanical ventilation. Respir Care 2009;54(3):367–374.
    OpenUrlAbstract/FREE Full Text
  60. 60.↵
    1. Copnell B
    . Effect of endotracheal suction on lung dynamics in mechanically-ventilated paediatric patients. Nurs Crit Care 2008;13(1):54–55.
    OpenUrlPubMed
  61. 61.↵
    1. Caruso P,
    2. Denari S,
    3. Ruiz SA,
    4. Demarzo SE,
    5. Deheinzelin D
    . Saline instillation before tracheal suctioning decreases the incidence of ventilator-associated pneumonia. Crit Care Med 2009;37(1):32–38.
    OpenUrlCrossRefPubMed
  62. 62.↵
    1. Christensen RD,
    2. Henry E,
    3. Baer VL,
    4. Hoang N,
    5. Snow GL,
    6. Rigby G,
    7. et al
    . A low-sodium solution for airway care: results of a multicenter trial. Respir Care 55(12):1680–1685.
  63. 63.↵
    1. Helder OK,
    2. Latour JM
    . Endotracheal suctioning: there's more to it than just technical care. Pediatr Crit Care Med 2008;9(5):539–540.
    OpenUrlPubMed
  64. 64.↵
    1. Pneumatikos IA,
    2. Dragoumanis CK,
    3. Bouros DE
    . Ventilator-associated pneumonia or endotracheal tube-associated pneumonia? An approach to the pathogenesis and preventive strategies emphasizing the importance of endotracheal tube. Anesthesiology 2009;110(3):673–680.
    OpenUrlCrossRefPubMedWeb of Science
  65. 65.↵
    1. Donahue M
    . “Spare the cough, spoil the airway:” back to the basics in airway clearance. Pediatr Nurs 2002;28(2):107–111.
    OpenUrlPubMed
  66. 66.↵
    1. Gaston B,
    2. Kelly R,
    3. Urban P,
    4. Liu L,
    5. Henderson EM,
    6. Doctor A,
    7. et al
    . Buffering airway acid decreases exhaled nitric oxide in asthma. J Allergy Clin Immunol 2006;118(4):817–822.
    OpenUrlCrossRefPubMedWeb of Science
  67. 67.↵
    1. Rau J
    . Mucous-controlling, surface-active, and cold and cough agents. In: Respiratory Care Pharmacology. Chicago: Year Book, 1989;144–179.
  68. 68.↵
    1. Connolly MA
    . Mucolytics and the critically ill patient: help or hindrance? AACN Clin Issues 1995;6(2):307–315.
    OpenUrlPubMed
  69. 69.↵
    American Association for Respiratory Care. Clinical practice guideline: Postural drainage therapy. Respir Care 1991;36(12):1418–1426.
    OpenUrlPubMed
  70. 70.↵
    1. da Silva VM,
    2. Lopes MV,
    3. de Araujo TL,
    4. Ciol MA,
    5. de Carvalho EC
    . Clinical indicators of ineffective airway clearance in children with congenital heart disease. J Clin Nurs 2009;18(5):729–736.
    OpenUrlPubMed
  71. 71.↵
    1. Hess D
    . The AARC (American Association for Respiratory Care) clinical practice guidelines. Respir Care 1991;36(12):1398–1401.
    OpenUrlPubMed
  72. 72.↵
    1. Schechter MS
    . Airway clearance applications in infants and children. Respir Care 2007;52(10):1382–1390; discussion 1390-1391.
    OpenUrlAbstract/FREE Full Text
  73. 73.↵
    1. Tripathi RS,
    2. Blum JM,
    3. Rosenberg AL,
    4. Tremper KK
    . Pulse oximetry saturation to fraction inspired oxygen ratio as a measure of hypoxia under general anesthesia and the influence of positive end-expiratory pressure. J Crit Care 2010;25(3):542; e549-513.
    OpenUrl
  74. 74.↵
    1. Vandenplas Y,
    2. Diericx A,
    3. Blecker U,
    4. Lanciers S,
    5. Deneyer M
    . Esophageal pH monitoring data during chest physiotherapy. J Pediatr Gastroenterol Nutr 1991;13(1):23–26.
    OpenUrlPubMedWeb of Science
  75. 75.↵
    1. Button BM,
    2. Heine RG,
    3. Catto-Smith AG,
    4. Phelan PD,
    5. Olinsky A
    . Chest physiotherapy, gastro-oesophageal reflux, and arousal in infants with cystic fibrosis. Arch Dis Child 2004;89(5):435–439.
    OpenUrlAbstract/FREE Full Text
  76. 76.↵
    1. Oberwaldner B,
    2. Zach MS
    . [Mucous clearing respiratory-physiotherapy in pediatric pneumology]. Schweiz Med Wochenschr 2000;130(19):711–719. Article in German.
    OpenUrlPubMed
  77. 77.↵
    1. Siew ML,
    2. Te Pas AB,
    3. Wallace MJ,
    4. Kitchen MJ,
    5. Lewis RA,
    6. Fouras A,
    7. et al
    . Positive end-expiratory pressure enhances development of a functional residual capacity in preterm rabbits ventilated from birth. J Appl Physiol 2009;106(5):1487–1493.
    OpenUrlAbstract/FREE Full Text
  78. 78.↵
    1. Zidulka A,
    2. Chrome JF,
    3. Wight DW,
    4. Burnett S,
    5. Bonnier L,
    6. Fraser R
    . Clapping or percussion causes atelectasis in dogs and influences gas exchange. J Appl Physiol 1989;66(6):2833–2838.
    OpenUrlAbstract/FREE Full Text
  79. 79.↵
    1. Hough JL,
    2. Flenady V,
    3. Johnston L,
    4. Woodgate PG
    . Chest physiotherapy for reducing respiratory morbidity in infants requiring ventilatory support. Cochrane Database Syst Rev 2008(3):CD006445.
  80. 80.↵
    1. Ernst MM,
    2. Wooldridge JL,
    3. Conway E,
    4. Dressman K,
    5. Weiland J,
    6. Tucker K,
    7. et al
    . Using quality improvement science to implement a multidisciplinary behavioral intervention targeting pediatric inpatient airway clearance. J Pediatr Psychol 35(1):14–24.
  81. 81.↵
    1. Hess DR
    . Secretion clearance techniques: absence of proof or proof of absence? (editorial) Respir Care 2002;47(7):757–758.
    OpenUrl
  82. 82.↵
    1. Fink JB
    . Positive pressure techniques for airway clearance. Respir Care 2002;47(7):786–796.
    OpenUrlPubMed
  83. 83.↵
    1. Lamb D,
    2. Reid L
    . The tracheobronchial submucosal glands in cystic fibrosis: a qualitative and quantitative histochemical study. Br J Dis Chest 1972;66(4):240–247.
    OpenUrl
  84. 84.↵
    1. Zuelzer W,
    2. Newton W
    . The pathogenesis of fibrocystic disease of the pancreas: a study of 36 cases with special reference to pulmonary lesions. Pediatrics 1949;4(1):53–69.
    OpenUrlAbstract/FREE Full Text
  85. 85.↵
    1. Katz S,
    2. Holsclaw DS Jr.
    . Ultrastructural features of respiratory cilia in cystic fibrosis. Am J Clin Pathol 1980;73(5):682–685.
    OpenUrlPubMedWeb of Science
  86. 86.↵
    1. Flume PA,
    2. Robinson KA,
    3. O'Sullivan BP,
    4. Finder JD,
    5. Vender RL,
    6. Willey-Courand DB,
    7. et al
    . Cystic fibrosis pulmonary guidelines: airway clearance therapies. Respir Care 2009;54(4):522–537.
    OpenUrlAbstract/FREE Full Text
  87. 87.↵
    1. Varekojis SM,
    2. Douce FH,
    3. Flucke RL,
    4. Filbrun DA,
    5. Tice JS,
    6. McCoy KS,
    7. et al
    . A comparison of the therapeutic effectiveness of and preference for postural drainage and percussion, intrapulmonary percussive ventilation, and high-frequency chest wall compression in hospitalized cystic fibrosis patients. Respir Care 2003;48(1):24–28.
    OpenUrlAbstract/FREE Full Text
  88. 88.↵
    1. Asher MI,
    2. Douglas C,
    3. Airy M,
    4. Andrews D,
    5. Trenholme A
    . Effects of chest physical therapy on lung function in children recovering from acute severe asthma. Pediatr Pulmonol 1990;9(3):146–151.
    OpenUrlCrossRefPubMedWeb of Science
  89. 89.↵
    1. Girard JP,
    2. Terki N
    . The Flutter VRP1: a new personal pocket therapeutic device used as an adjunct to drug therapy in the management of bronchial asthma. J Investig Allergol Clin Immunol 1994;4(1):23–27.
    OpenUrlPubMed
  90. 90.↵
    1. Myers TR
    . Positive expiratory pressure and oscillatory positive expiratory pressure therapies. Respir Care 2007;52(10):1308–1326; discussion 1327.
    OpenUrlAbstract/FREE Full Text
  91. 91.↵
    1. Gupta VK,
    2. Cheifetz IM
    . Heliox administration in the pediatric intensive care unit: an evidence-based review. Pediatr Crit Care Med 2005;6(2):204–211.
    OpenUrlCrossRefPubMed
  92. 92.↵
    1. Anderson M,
    2. Svartengren M,
    3. Bylin G,
    4. Philipson K,
    5. Camner P
    . Deposition in asthmatics of particles inhaled in air or in helium-oxygen. Am Rev Respir Dis 1993;147(3):524–528.
    OpenUrlPubMedWeb of Science
  93. 93.↵
    1. Kass JE,
    2. Terregino CA
    . The effect of heliox in acute severe asthma: a randomized controlled trial. Chest 1999;116(2):296–300.
    OpenUrlCrossRefPubMedWeb of Science
  94. 94.↵
    1. Bach JR,
    2. Saporito LR
    . Criteria for extubation and tracheostomy tube removal for patients with ventilatory failure. A different approach to weaning. Chest 1996;110(6):1566–1571.
    OpenUrlCrossRefPubMedWeb of Science
  95. 95.↵
    1. Panitch HB
    . Respiratory issues in the management of children with neuromuscular disease. Respir Care 2006;51(8):885–893; discussion 894-885.
    OpenUrlAbstract/FREE Full Text
  96. 96.↵
    1. Dohna-Schwake C,
    2. Ragette R,
    3. Teschler H,
    4. Voit T,
    5. Mellies U
    . IPPB-assisted coughing in neuromuscular disorders. Pediatr Pulmonol 2006;41(6):551–557.
    OpenUrlCrossRefPubMed
  97. 97.
    1. Panitch HB
    . Airway clearance in children with neuromuscular weakness. Curr Opin Pediatr. 2006;18(3):277–281.
    OpenUrlCrossRefPubMed
  98. 98.
    1. Miske LJ,
    2. Hickey EM,
    3. Kolb SM,
    4. Weiner DJ,
    5. Panitch HB
    . Use of the mechanical in-exsufflator in pediatric patients with neuromuscular disease and impaired cough. Chest 2004;125(4):1406–1412.
    OpenUrlCrossRefPubMedWeb of Science
  99. 99.
    1. Birnkrant DJ,
    2. Pope JF,
    3. Lewarski J,
    4. Stegmaier J,
    5. Besunder JB
    . Persistent pulmonary consolidation treated with intrapulmonary percussive ventilation: a preliminary report. Pediatr Pulmonol 1996;21(4):246–249.
    OpenUrlCrossRefPubMedWeb of Science
  100. 100.
    1. Deakins K,
    2. Chatburn RL
    . A comparison of intrapulmonary percussive ventilation and conventional chest physiotherapy for the treatment of atelectasis in the pediatric patient. Respir Care 2002;47(10):1162–1167.
    OpenUrlPubMed
  101. 101.
    1. Toussaint M,
    2. De Win,
    3. Steens M,
    4. Soudon P
    . Effect of intrapulmonary percussive ventilation on mucus clearance in duchenne muscular dystrophy patients: a preliminary report. Respir Care 2003;48(10):940–947.
    OpenUrlPubMed
  102. 102.↵
    1. Vianello A,
    2. Corrado A,
    3. Arcaro G,
    4. Gallan F,
    5. Ori C,
    6. Minuzzo M,
    7. et al
    . Mechanical insufflation-exsufflation improves outcomes for neuromuscular disease patients with respiratory tract infections. Am J Phys Med Rehabil 2005;84(2):83–88; discussion 89-91.
    OpenUrlCrossRefPubMedWeb of Science
  103. 103.↵
    1. Striegl AM,
    2. Redding GJ,
    3. Diblasi R,
    4. Crotwell D,
    5. Salyer J,
    6. Carter ER
    . Use of a lung model to assess mechanical in-exsufflator therapy in infants with tracheostomy. Pediatr Pulmonol 2010 [Epub ahead of print].
  104. 104.↵
    1. Plioplys AV
    . Correspondence on “safety, tolerability, and efficacy of high-frequency chest wall oscillation in pediatric patients with cerebral palsy and neuromuscular diseases: an exploratory randomized controlled trial”. J Child Neurol 2010;25(12):1598; author reply 1598.
    OpenUrlFREE Full Text
  105. 105.↵
    1. Perrotta C,
    2. Ortiz Z,
    3. Roque M
    . Chest physiotherapy for acute bronchiolitis in paediatric patients between 0 and 24 months old. Cochrane Database Syst Rev 2007(1):CD004873.
  106. 106.↵
    Subcommittee on Diagnosis and Management of Bronchiolitis. Diagnosis and management of bronchiolitis. Pediatrics 2006;118(4):1774–1793.
    OpenUrlAbstract/FREE Full Text
  107. 107.↵
    1. Bailleux S,
    2. Lopes D,
    3. Geoffroy A,
    4. Josse N,
    5. Labrune P,
    6. Gajdos V
    . [What evidence for chest physiotherapy in infants hospitalized for acute viral bronchiolitis?]. Arch Pediatr 2011;18(4):472–475. Article in French.
    OpenUrlPubMed
  108. 108.↵
    1. Gajdos V,
    2. Katsahian S,
    3. Beydon N,
    4. Abadie V,
    5. de Pontual L,
    6. Larrar S,
    7. et al
    . Effectiveness of chest physiotherapy in infants hospitalized with acute bronchiolitis: a multicenter, randomized, controlled trial. PLoS Med 2010;7(9):e1000345.
    OpenUrlCrossRefPubMed
  109. 109.↵
    1. Reines HD,
    2. Sade RM,
    3. Bradford BF,
    4. Marshall J
    . Chest physiotherapy fails to prevent postoperative atelectasis in children after cardiac surgery. Ann Surg 1982;195(4):451–455.
    OpenUrlCrossRefPubMedWeb of Science
  110. 110.↵
    1. Flenady VJ,
    2. Gray PH
    . Chest physiotherapy for preventing morbidity in babies being extubated from mechanical ventilation. Cochrane Database Syst Rev 2002(2):CD000283.
  111. 111.↵
    1. Levin AN
    . [Classification of acute pneumonia in children]. Pediatriia 1978(4):69–70. Article in Russian.
  112. 112.↵
    1. Stapleton T
    . Chest physiotherapy in primary pneumonia. BMJ (Clin Res Ed) 1985;291(6488):143.
    OpenUrlFREE Full Text
  113. 113.↵
    1. Britton S,
    2. Bejstedt M,
    3. Vedin L
    . Chest physiotherapy in primary pneumonia. BMJ (Clin Res Ed) 1985;290(6483):1703–1704.
    OpenUrlAbstract/FREE Full Text
Back to top

In this issue

 

Print
Download PDF
Article Alerts
Email Article
Citation Tools

Jump to section

Related Articles

Cited By...

Keywords