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Review ArticleInvited Review

Airway Clearance Techniques for Mechanically Ventilated Patients: Insights for Optimization

Marcia S Volpe, Fernando S Guimarães and Caio CA Morais
Respiratory Care August 2020, 65 (8) 1174-1188; DOI: https://doi.org/10.4187/respcare.07904
Marcia S Volpe
Department of Sciences of Human Movement, Federal University of São Paulo, Santos, São Paulo, Brazil.
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  • For correspondence: [email protected]
Fernando S Guimarães
Physical Therapy Department, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil.
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Caio CA Morais
Pulmonary Division, Heart Institute, Hospital das Clinicas, University of São Paulo, São Paulo, Brazil.
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Abstract

Secretion management in mechanically ventilated patients is a paramount task for clinicians. A better understanding of the mechanisms of flow bias and airway dynamic compression during airway clearance therapy may enable a more effective approach for this population. Ventilator hyperinflation, expiratory rib cage compression, a PEEP-ZEEP maneuver, and mechanical insufflation-exsufflation are examples of techniques that can be optimized according to such mechanisms. In addition, novel technologies, such as electric impedance tomography, may help improve airway clearance therapy by monitoring the consequences of regional secretion displacement on lung aeration and regional lung mechanics.

  • airway clearance/secretion management
  • mechanical ventilation
  • physiotherapy
  • physical therapy
  • sputum
  • ventilator hyperinflation

Footnotes

  • Correspondence: Marcia S Volpe PT PhD, Department of Sciences of Human Movement, UNIFESP – Campus Baixada Santista, Rua Silva Jardim, 136, CEP 11015-020, Santos, São Paulo, Brasil. E-mail: marciasvolpe{at}gmail.com
  • Dr Morais has disclosed a relationship with Timpel SA. The other authors have disclosed no conflicts of interest.

  • Copyright © 2020 by Daedalus Enterprises
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Respiratory Care: 65 (8)
Respiratory Care
Vol. 65, Issue 8
1 Aug 2020
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Airway Clearance Techniques for Mechanically Ventilated Patients: Insights for Optimization
Marcia S Volpe, Fernando S Guimarães, Caio CA Morais
Respiratory Care Aug 2020, 65 (8) 1174-1188; DOI: 10.4187/respcare.07904

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Airway Clearance Techniques for Mechanically Ventilated Patients: Insights for Optimization
Marcia S Volpe, Fernando S Guimarães, Caio CA Morais
Respiratory Care Aug 2020, 65 (8) 1174-1188; DOI: 10.4187/respcare.07904
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Keywords

  • airway clearance/secretion management
  • mechanical ventilation
  • physiotherapy
  • physical therapy
  • sputum
  • ventilator hyperinflation

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