Expiratory Rib Cage Compressions to Improve Secretion Clearance During Mechanical Ventilation: Not Only a Matter of Squeezing the Chest—Reply

Guimarães, Fernando Silva; Menezes, Sara Lucia Silveira de; Lopes, Agnaldo José

doi:10.4187/respcare.03522

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Expiratory Rib Cage Compression1

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2020

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“…Regarding its objectives, ERRC is usually applied either to assist with secretion movement from distal to proximal airways, or to remove secretion from large airways. 45,46 In theory, if ERRC is applied with gradual intensity (from gentle to strong) to prolong exhalation after the onset of the expiratory phase, it removes secretions from distal airways. On the other hand, if ERRC is applied with hard compressions to increase PEF and synchronized with the onset of expiration, it removes secretions from proximal airways.…”

Section: Expiratory Rib Cage Compressionmentioning

confidence: 99%

Airway Clearance Techniques for Mechanically Ventilated Patients: Insights for Optimization

2020

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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.

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Section: Expiratory Rib Cage Compressionmentioning

confidence: 99%