Tos ineficaz y técnicas mecánicas de aclaramiento mucociliar

Fernández-Carmona, A.; Olivencia-Peña, L.; Yuste-Ossorio, M.E.; Peñas-Maldonado, L.

doi:10.1016/j.medin.2017.05.003

Cited by 8 publications

(1 citation statement)

References 46 publications

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“…Cough is a fundamental defence mechanism, with two key functions. It protects the respiratory system from foreign particles and clears airway secretions (Fernández-Carmona et al, 2018). Cough clearance is vital for excessive mucus or when mucociliary clearance mechanisms are injured or insufficient (King, 1998).…”

Section: Coughmentioning

confidence: 99%

Identifying and Understanding Risk Factors for Instability and Adverse Events Associated With Chest Physiotherapy in Ventilated Children

2019

CMR

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BackgroundChest physiotherapy is a treatment option for ventilated children. Evidence supporting treatment effectiveness is limited and the safety profile is unknown.This study aimed to identify and understand risk factors for physiological instability and adverse events associated with chest physiotherapy in ventilated children. MethodsThis was a convergent mixed methods study.Work package 1: Explanatory sequential study to describe current physiotherapy practice and explore decision making, utilising an anonymous questionnaire, semi-structured interviews, focus groups, and document analysis. Work package 2:Retrospective single-centre study, using high-resolution data and electronic patient records. Mechanically ventilated children, aged 0-4 years, receiving chest physiotherapy were included. The primary outcome was oxygen saturation index (OSI). Incidence of adverse events (change ≥0.3) in the 60 minutes post-physiotherapy was investigated. ResultsThe questionnaire was sent to 26/27 (96%) UK paediatric intensive care units, with a response rate of 61% (72/118). Sixteen physiotherapist interviews and two focus groups (n=7) were completed. Twenty-nine organisational documents were analysed. The most frequently used techniques were position changes, saline instillation, manual hyperinflations and chest wall vibrations. Variation in practice included the personnel involved in treatments. Clinical decision making was described as complex, iterative, and collaborative, with experience and expertise important factors. OSI data were available for 247 patients. OSI adverse event rates were between 7.4%-9.3%. The highest rate was recorded in the 5 minutes immediately post-ARDS Acute respiratory distress syndrome ASL Airway surface liquid BD Twice daily CAQDAS Computer assisted qualitative data analysis software CF Cystic Fibrosis CICU Cardiac intensive care unit CO2 Carbon dioxide COPD Chronic obstructive pulmonary disease COVID19 Severe acute respiratory syndrome coronavirus 2 2019 pandemic CPB Cardiopulmonary bypass CPT Chest physiotherapy CS Closed suction CVVH Continuous veno-venous haemofiltration CWV Chest wall vibrations CXR Chest x-ray

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Section: Coughmentioning

confidence: 99%

Identifying and Understanding Risk Factors for Instability and Adverse Events Associated With Chest Physiotherapy in Ventilated Children

2019

CMR

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Effect of expiratory muscle training on peak cough flow in children and adolescents with cystic fibrosis: A randomized controlled trial

Emirza

Aslan

Kılınç

et al. 2021

Pediatric Pulmonology

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Background Cough is an important defense and airway clearance mechanism for removing thick and viscous secretions in cystic fibrosis (CF). The primary aim of this study was to investigate the effect of expiratory muscle training (EMT) on peak cough flow (PCF) and secondly on respiratory muscle functions, functional exercise capacity, and quality of life (QoL) in CF. Methods Thirty patients were randomized as training and sham groups. Both groups were trained with the EMT protocol, which involved twice per day for at least 5 days per week for 6 weeks. The training intensity in the training group was 30% of the maximal expiratory pressure (MEP). In the sham group, it remained at the lowest pressure (5 cmH2O). The primary outcome was PCF. The secondary outcomes were MEP, maximal inspiratory pressure (MIP), spirometric measures, six‐minute walking distance (6MWD), and QoL (Cystic Fibrosis Questionnaire‐Revised). Results Twenty‐eight patients completed the study. Changes in PCF (p = .041) and MEP (p = .003) were higher in the training group than the sham group. Also, treatment burden (p = .008), digestive symptoms (p = .019), and vitality (p = .042) in QoL were more improved in the training group. MIP (p = .028) and 6MWD (p = .035) changed significantly only in the training group. Spirometric measurements did not change (p > .05). Conclusions The results of the study show that EMT could improve PCF, MEP, treatment burden, digestive symptoms, and vitality domains of QoL in patients with CF. Moreover, MIP and functional exercise capacity improved in the training group with EMT.

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Aerobic exercise capacity, cough strength, posture, and depression in primary ciliary dyskinesia

FIRAT

Boşnak-Güçlü

Eyüboğlu

et al. 2022

Pediatric Pulmonology

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Introduction: Assessment of exercise capacity is important for information about lung function and prognosis in primary ciliary dyskinesia (PCD). In addition, deterioration in the pulmonary system may affect cough efficiency, posture, and thoracoabdominal mobility. In turn, this deterioration may also disturb the psychological function of patients with PCD. Therefore, this study aimed to compare exercise capacity, cough strength, thoracoabdominal mobility, posture, and depression in children with PCD and healthy peers.Methods: Twenty-seven patients with PCD and 28 healthy peers were included.Aerobic exercise capacity (3-min step test), cough strength (peak expiratory flow meter), thoracoabdominal mobility (upper chest, lower chest, and abdomen), posture (Corbin postural assessment scale), and depression (Children's Depression Inventory) were evaluated.Results: Patients' number of steps completed, cough strength, and thoracoabdominal mobility were significantly decreased; total posture and depression scores were higher compared with healthy controls (p< 0.05). There was a significant relationship between cough strength and maximal expiratory strength (r = 0.541, p= 0.004) and total number of steps (r = 0.509, p= 0.007) in the patients. Conclusion: Aerobic exercise capacity, cough strength, and thoracoabdominal mobility were impaired, posture was deteriorated, and depression perception elevated in children with PCD compared to healthy peers. Furthermore, aerobic exercise capacity and maximal expiratory strength are related to cough strength in these patients. Rehabilitation programs including aerobic and resistive exercise training, deep breathing and postural exercise, and nutrition counseling may improve these results and better be investigated. Trial registration: Clinicaltrials.gov: NCT03370029; December 12, 2017.

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Tos ineficaz y técnicas mecánicas de aclaramiento mucociliar

Cited by 8 publications

References 46 publications

Identifying and Understanding Risk Factors for Instability and Adverse Events Associated With Chest Physiotherapy in Ventilated Children

Identifying and Understanding Risk Factors for Instability and Adverse Events Associated With Chest Physiotherapy in Ventilated Children

Effect of expiratory muscle training on peak cough flow in children and adolescents with cystic fibrosis: A randomized controlled trial

Aerobic exercise capacity, cough strength, posture, and depression in primary ciliary dyskinesia

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