[Airway clearance techniques in chronic obstructive pulmonary syndrome : 2011 update]

Area of Science:

• Pulmonary Medicine
• Respiratory Therapy

Context:

• Traditional airway clearance techniques (ACTs) in chest physical therapy, including postural drainage, percussion, and vibration, have been widely used.
• Concerns regarding side effects, contraindications, and limited scientific evidence have driven the development of alternative ACTs.
• Despite demonstrating efficacy in enhancing mucociliary clearance, the long-term benefits of these techniques on lung function and arterial blood gases are not well-established.

Purpose:

• To review the scientific literature on the efficacy of ACTs in various obstructive pulmonary diseases.
• To highlight the variability in recognition and documentation of ACT effectiveness across different conditions.
• To emphasize the need for individualized ACT selection based on patient-specific factors.

Summary:

• ACTs show high efficiency in improving mucociliary clearance across different obstructive lung diseases.
• However, their short- and long-term effects on lung function and arterial blood gases are minimally documented.
• Efficacy is well-established in cystic fibrosis but poorly documented in non-cystic fibrosis bronchiectasis, bronchitis, and emphysema.

Impact:

• ACTs require individualization based on symptoms, mucus production, and signs of secretion retention for optimal patient management.
• This approach acknowledges the limitations of current evidence and promotes tailored respiratory care.
• Further research is needed to clarify the long-term benefits of ACTs in specific obstructive pulmonary diseases.