1. Airway clearance techniques in neuromuscular disorders: A state of the art review
- Author
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Miguel R. Gonçalves, Nicole Sheers, David J Berlowitz, Michelle Chatwin, Tiina Andersen, Marcello Villanova, Daniel W. Sheehan, Uwe Mellies, Kathy Kinnett, Mike J. Kampelmacher, Matthieu Lacombe, Brit Hov, Brigitte Fauroux, Malin Nygren-Bonnier, Fabrizio Rao, Brenda M. Morrow, Jesus Sancho, Christian Devaux, Michel Toussaint, Jesus Gonzales-Bermejo, Kurt Pernet, Neurophysiologie Respiratoire Expérimentale et Clinique, Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Sorbonne Université - Faculté de Médecine (SU FM), Sorbonne Université (SU), Service de Pneumologie et Réanimation Médicale [CHU Pitié-Salpêtrière] (Département ' R3S '), CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service d'assistance respiratoire et sommeil de l'enfant [CHU Necker], CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris Descartes - Paris 5 (UPD5), Bergen University College, Oslo University Hospital [Oslo], Karolinska Institutet [Stockholm], Hôpital Raymond Poincaré [AP-HP], University Medical Center [Utrecht], Association française contre les myopathies (AFM-Téléthon), University at Buffalo [SUNY] (SUNY Buffalo), State University of New York (SUNY), University of Milan, University of Cape Town, and Neurophysiologie Respiratoire Expérimentale et Clinique (UMRS 1158)
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Airway clearance ,Neuromuscular disease ,[SDV]Life Sciences [q-bio] ,Medizin ,Respiratory failure ,[SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract ,Homecare ,03 medical and health sciences ,0302 clinical medicine ,Physical medicine and rehabilitation ,Tracheostomy ,medicine ,Humans ,In patient ,Amyotrophic lateral sclerosis ,business.industry ,Lung volume measurement ,State of the art review ,Neuromuscular Diseases ,medicine.disease ,Respiration, Artificial ,Respiratory Muscles ,3. Good health ,Systematic review ,030228 respiratory system ,Cough ,Inhalation ,Mucociliary Clearance ,Non-invasive ventilation ,business ,Lung Volume Measurements ,Respiratory Insufficiency ,030217 neurology & neurosurgery - Abstract
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.
- Published
- 2018
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