TY - JOUR
T1 - Airway clearance techniques in neuromuscular disorders
T2 - A state of the art review
AU - Chatwin, Michelle
AU - Toussaint, Michel
AU - Gonçalves, Miguel R.
AU - Sheers, Nicole
AU - Mellies, Uwe
AU - Gonzales-Bermejo, Jesus
AU - Sancho, Jesus
AU - Fauroux, Brigitte
AU - Andersen, Tiina
AU - Hov, Brit
AU - Nygren-Bonnier, Malin
AU - Lacombe, Matthieu
AU - Pernet, Kurt
AU - Kampelmacher, Mike
AU - Devaux, Christian
AU - Kinnett, Kathy
AU - Sheehan, Daniel
AU - Rao, Fabrizio
AU - Villanova, Marcello
AU - Berlowitz, David
AU - Morrow, Brenda M.
N1 - Publisher Copyright:
© 2018 The Authors
PY - 2018/3
Y1 - 2018/3
N2 - This is a unique state of the art review written by a group of 21 international recognized experts in the field that gathered during a meeting organized by the European Neuromuscular Centre (ENMC) in Naarden, March 2017. It systematically reports the entire evidence base for airway clearance techniques (ACTs) in both adults and children with neuromuscular disorders (NMD). We not only report randomised controlled trials, which in other systematic reviews conclude that there is a lack of evidence base to give an opinion, but also include case series and retrospective reviews of practice. For this review, we have classified ACTs as either proximal (cough augmentation) or peripheral (secretion mobilization). The review presents descriptions; standard definitions; the supporting evidence for and limitations of proximal and peripheral ACTs that are used in patients with NMD; as well as providing recommendations for objective measurements of efficacy, specifically for proximal ACTs. This state of the art review also highlights how ACTs may be adapted or modified for specific contexts (e.g. in people with bulbar insufficiency; children and infants) and recommends when and how each technique should be applied.
AB - This is a unique state of the art review written by a group of 21 international recognized experts in the field that gathered during a meeting organized by the European Neuromuscular Centre (ENMC) in Naarden, March 2017. It systematically reports the entire evidence base for airway clearance techniques (ACTs) in both adults and children with neuromuscular disorders (NMD). We not only report randomised controlled trials, which in other systematic reviews conclude that there is a lack of evidence base to give an opinion, but also include case series and retrospective reviews of practice. For this review, we have classified ACTs as either proximal (cough augmentation) or peripheral (secretion mobilization). The review presents descriptions; standard definitions; the supporting evidence for and limitations of proximal and peripheral ACTs that are used in patients with NMD; as well as providing recommendations for objective measurements of efficacy, specifically for proximal ACTs. This state of the art review also highlights how ACTs may be adapted or modified for specific contexts (e.g. in people with bulbar insufficiency; children and infants) and recommends when and how each technique should be applied.
KW - Homecare
KW - Neuromuscular disease
KW - Non-invasive ventilation
KW - Respiratory failure
KW - Tracheostomy
UR - https://www.scopus.com/pages/publications/85042234283
U2 - 10.1016/j.rmed.2018.01.012
DO - 10.1016/j.rmed.2018.01.012
M3 - Review article
C2 - 29501255
AN - SCOPUS:85042234283
SN - 0954-6111
VL - 136
SP - 98
EP - 110
JO - Respiratory Medicine
JF - Respiratory Medicine
ER -