Positive expiratory pressure physiotherapy for airway clearance in people with cystic fibrosis

McIlwaine, Maggie; Button, Brenda; Dwan, Kerry

doi:10.1002/14651858.cd003147.pub4

Cited by 66 publications

(20 citation statements)

References 43 publications

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“…Some patients prefer to use handheld vibratory positive expiratory pressure devices, which similarly provide distending PEEP while adding the element of vibratory airflow which is thought to help break up mucus and move it up the mucociliary ladder. PEEP devices have compared favorably to HFCWO therapy in systematic review, particularly in terms of reduction in pulmonary exacerbation frequency and in patient satisfaction (71).…”

Section: Positive Expiratory Pressure Devicesmentioning

confidence: 99%

Bronchiectasis in Primary Antibody Deficiencies: A Multidisciplinary Approach

2020

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Bronchiectasis, the presence of bronchial wall thickening with airway dilatation, is a particularly challenging complication of primary antibody deficiencies. While susceptibility to infections may be the primary factor leading to the development of bronchiectasis in these patients, the condition may develop in the absence of known infections. Once bronchiectasis is present, the lungs are subject to a progressive cycle involving both infectious and non-infectious factors. If bronchiectasis is not identified or not managed appropriately, the cycle proceeds unchecked and yields advanced and permanent lung damage. Severe symptoms may limit exercise tolerance, require frequent hospitalizations, profoundly impair quality of life (QOL), and lead to early death. This review article focuses on the appropriate identification and management of bronchiectasis in patients with primary antibody deficiencies. The underlying immune deficiency and the bronchiectasis need to be treated from combined immunology and pulmonary perspectives, reflected in this review by experts from both fields. An aggressive multidisciplinary approach may reduce exacerbations and slow the progression of permanent lung damage.

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Section: Positive Expiratory Pressure Devicesmentioning

confidence: 99%

Bronchiectasis in Primary Antibody Deficiencies: A Multidisciplinary Approach

2020

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“…Patient preference is an essential factor for adherence to treatment, but the use of devices such as positive expiratory pressure masks and oscillatory positive expiratory pressure devices such as the Flutter ® , the Shaker ® , and the Acapella ® is of great value and gives the patient independence. 71 The use of high-frequency chest wall oscillation devices, despite also giving the patient independence, was found to be inferior to the use of positive expiratory pressure masks in a recent study. 72 Noninvasive ventilation may be used as an adjunct to airway clearance therapy and in patients with advanced disease and hypercapnic respiratory failure.…”

Section: Treatment Of Respiratory Diseasementioning

confidence: 91%

Brazilian guidelines for the diagnosis and treatment of cystic fibrosis

et al. 2017

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Cystic fibrosis (CF) is an autosomal recessive genetic disorder characterized by dysfunction of the CFTR gene. It is a multisystem disease that most often affects White individuals. In recent decades, various advances in the diagnosis and treatment of CF have drastically changed the scenario, resulting in a significant increase in survival and quality of life. In Brazil, the current neonatal screening program for CF has broad coverage, and most of the Brazilian states have referral centers for the follow-up of individuals with the disease. Previously, CF was limited to the pediatric age group. However, an increase in the number of adult CF patients has been observed, because of the greater number of individuals being diagnosed with atypical forms (with milder phenotypic expression) and because of the increase in life expectancy provided by the new treatments. However, there is still great heterogeneity among the different regions of Brazil in terms of the access of CF patients to diagnostic and therapeutic methods. The objective of these guidelines was to aggregate the main scientific evidence to guide the management of these patients. A group of 18 CF specialists devised 82 relevant clinical questions, divided into five categories: characteristics of a referral center; diagnosis; treatment of respiratory disease; gastrointestinal and nutritional treatment; and other aspects. Various professionals working in the area of CF in Brazil were invited to answer the questions devised by the coordinators. We used the PubMed database to search the available literature based on keywords, in order to find the best answers to these questions.

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“…O paciente inspira e expira dentro da máscara em torno de 15 vezes e no período de descanso realiza-se respirações fora da máscara. Esse procedimento é repetido por volta de 20 minutos e comumente feito 2 vezes ao dia (MCLLWAINE et al, 2015;OLSÉN et al, 2015).…”

Section: Pressão Expiratória Positiva (Pep)unclassified

Atuação Do Fisioterapeuta No Atendimento a Pacientes Com Fibrose Cística: Uma Revisão De Literatura

Silva¹,

Santos²,

Vinhal³

et al. 2017

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RESUMOA fibrose cística é uma doença autossômica recessiva, pleiotrópica e deletéria, que compromete o funcionamento dos sistemas digestivo, musculoesquelético e respiratório. Essa revisão de literatura abordou a atuação do fisioterapeuta no atendimento a pacientes com fibrose cística mediante dados bibliográficos disponíveis no PubMed, SciELO e PEDro entre os anos 2006 a 2016. Os resultados encontrados evidenciam que a fisioterapia tem um papel importante no tratamento do paciente com fibrose cística, promovendo principalmente a melhora da qualidade de vida e aumentado também a sobrevida. A atuação do fisioterapeuta no atendimento desses pacientes contempla: 1) fisioterapia respiratória, que auxilia na eliminação de secreções das vias aéreas em pacientes com fibrose cística utilizando técnicas clássicas e atuais como, drenagem postural, vibração e percussão, técnica de expiração forçada, técnica do ciclo ativo da respiração, pressão expiratória positiva oscilatória -flutter, pressão expiratória positiva e drenagem autógena; 2) fisioterapia nas alterações musculoesqueléticas, que inclui exercícios de cinesioterapia com resistência para a melhora da força muscular do paciente; 3) terapia manual visceral, que estimula e aumenta o peristaltismo, auxilia a secreção de fluidos glandulares, reduz o tempo de trânsito colônico e diminui a dor e o desconforto causados pelas disfunções digestivas; 4) o envolvimento e comprometimento da família, que aumenta a adesão do paciente ao tratamento e melhora efetivamente a avaliação prognóstica. Em conclusão, o tratamento fisioterapêutico da fibrose cística proporciona a melhora global do quadro fisiopatológico destes pacientes. PALAVRAS-CHAVE: CFTR, mucoviscosidade e técnicas fisioterapêuticas

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Positive expiratory pressure physiotherapy for airway clearance in people with cystic fibrosis

Cited by 66 publications

References 43 publications

Bronchiectasis in Primary Antibody Deficiencies: A Multidisciplinary Approach

Bronchiectasis in Primary Antibody Deficiencies: A Multidisciplinary Approach

Brazilian guidelines for the diagnosis and treatment of cystic fibrosis

Atuação Do Fisioterapeuta No Atendimento a Pacientes Com Fibrose Cística: Uma Revisão De Literatura

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