Cited by 326Cystic Fibrosis Research AdvancesRespiratory and Cough-Related ResearchRespiratory Support and Mechanisms

Airway clearance techniques in neuromuscular disorders: A state of the art review

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Chatwin, Michelle, Toussaint, Michel, Gonçalves, Miguel R., Sheers, Nicole, Mellies, Uwe, Gonzales-Bermejo, Jesus, Sancho, Jesus, Fauroux, Brigitte +13 more·2018·Respiratory Medicine

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.

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Crossref · 10.1016/j.rmed.2018.01.012

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  • Normal trans tracheal suctioning with a catheter is not completely effective in more than 90% of cases and peripheral secretions are not removed.

    “As shown by Chatwin, normal trans tracheal suctioning with a catheter is not completely effective in more than 90% of cases and thus peripheral secretions are not removed [52].”

    From Life Experiences in Neuromuscular Tracheotomized Patients in Times of Covid-19 (2023) · cites this paper as [52]

    Section 3.3.2.3 (page unavailable) says routine catheter suctioning does not directly remove secretions from peripheral airways. It does not report that suctioning is incompletely effective in more than 90% of cases; searches for that percentage found no supporting passage. (LLM, conf=0.88)

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Research works printed but not linked: 1

  1. G. Riffard, M. Toussaint, Indications for intrapulmonary percussive ventilation (IPV): a review of the literature, Rev. Mal. Respir. 29 (2) (2012) 178-190.

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Authors
Chatwin, M., Toussaint, M., Gonçalves, M. R., Sheers, N., Mellies, U., Gonzales-Bermejo, J., Sancho, J., Fauroux, B., Andersen, T., Hov, B., Nygren-Bonnier, M., Lacombe, M., Pernet, K., Kampelmacher, M., Devaux, C., Kinnett, K., Sheehan, D., Rao, F., Villanova, M., Berlowitz, D., & Morrow, B. M.
Affiliations
  • Royal Brompton & Harefield NHS Foundation Trust (GB)
  • Universidade do Porto (PT)
  • Institute for Breathing and Sleep (AU)
  • University of Duisburg-Essen (DE)
  • Hôpital Necker-Enfants Malades (FR)
  • Haukeland University Hospital (NO)
  • Oslo University Hospital (NO)
  • Assistance Publique – Hôpitaux de Paris (FR)
  • University Medical Center Utrecht (NL)
  • Association Francaise contre les Myopathies (FR)
  • Women & Children's Hospital of Buffalo (US)
  • University of Milan (IT)
  • University of Cape Town (ZA)
Corresponding author
Chatwin, Michelle
Venue
Respiratory Medicine
Publisher
Elsevier BV
Published
2018-03
Volume
136
Pages
98-110
ISSN
0954-6111 (ISSN-L)
OpenAlex
W2791843842
Cited by
325
References
127
Citations by year
2026: 31 · 2025: 45 · 2024: 45 · 2023: 58 · 2022: 45 · 2021: 35 · 2020: 29 · 2019: 26 · 2018: 11
FWCI
4.51
Type
journal article
Language
en
Open access
Locations
  • Respiratory Medicine (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • HAL (submittedVersion, other-oa)
  • Universitätsbibliographie, Universität Duisburg-Essen (submittedVersion)
Funders
  • NIHR Respiratory Disease Biomedical Research Unit at the Royal Brompton and Harefield NHS Foundation Trust and Imperial College London
  • “Investissement d’Avenir” ANR-10-AIHU 06 of the French Government
  • ResMed via the Royal Brompton Hospital
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cystic Fibrosis Research Advances
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory and Cough-Related Research
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
Keywords
airway clearance techniques, neuromuscular disorders, cough augmentation, secretion mobilization, infants and children, evidence base
MeSH terms
Inhalation, Cough, Humans, Lung Volume Measurements, Mucociliary Clearance, Neuromuscular Diseases, Respiration, Artificial, Respiratory Insufficiency, Respiratory Muscles

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