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Management of COVID-19 Rehabilitation Nursing
Published in Wenguang Xia, Xiaolin Huang, Rehabilitation from COVID-19, 2021
Education and cooperation of patients Explain the purpose and method of postural drainage before sputum discharge. Eliminate the patient’s tension so that they can cooperate well.Inform the patients and family members in a precise manner. Tell the patients to drink warm water during sputum discharge, to dilute the sputum and discharge efficiently.
Physical Therapy Recommendations for Patients with COVID-19
Published in Fadi Al-Turjman, AI-Powered IoT for COVID-19, 2020
Ayman A Mohamed, Motaz Alawna, Fadi Al-Turjman, Majdi Nassif
There are different types of pulmonary exercises that help in decreasing both moist or dry coughs. One of the most-used pulmonary exercises used to get rid of sputum, and that consequently improves the lung function, is postural drainage60. Percussion is another pulmonary technique that could be used to get rid of sputum and improve lung function61. Also, there are various pulmonary exercises that can be used to enhance the dry cough commonly seen in patients with COVID-19. As mentioned earlier, aerobic exercises improve the dry cough more than breathing exercises36, 37, because aerobic exercise causes autonomic modulation, which helps significantly in decreasing the bronchospasm mainly responsible for dry cough62.
Physiotherapy and airway clearance
Published in Claudio F. Donner, Nicolino Ambrosino, Roger S. Goldstein, Pulmonary Rehabilitation, 2020
Miguel R. Gonçalves, Amanda J. Piper
Techniques for augmenting normal mucociliary clearance and cough efficacy have been used for many years to treat patients with respiratory disorders from different aetiologies. In recent years, new technologies and more advanced techniques have been developed to aid airway clearance and lung expansion while being more comfortable and effective for the majority of patients. Postural drainage with manual chest percussion and shaking has, in most parts of the world, been replaced by more independent and effective techniques.
Care of children with home mechanical ventilation in the healthcare continuum
Published in Hospital Practice, 2021
Benjamin Kalm, Khanh Lai, Natalie Darro
In patients with poor respiratory strength, it is important to optimize airway clearance. Airway clearance techniques (ACTs) include postural drainage, percussion, chest wall vibration, and coughing. In children on HMV, recommended home equipment includes portable suctioning equipment, a heated humidifier, and a nebulizer/compressor [17]. Of note, many of our patients do not use nebulized medications and therefore do not have a nebulizer/compressor. A mechanical insufflation-exsufflation device (commonly called cough assist) may benefit children with HMV with ineffective cough, such as those with neuromuscular disease with respiratory muscle weakness. In children large enough for proper fitment, high-frequency chest wall oscillation is indicated for impaired clearance of secretions with impaired mobility. There is a lack of randomized controlled trials regarding choice of different ACT modalities in the pediatric HMV population.
Efficacy and safety of percutaneous tube drainage in lung abscess: a systematic review and meta-analysis
Published in Expert Review of Respiratory Medicine, 2020
Qibin Lin, Minli Jin, Yacan Luo, Meixi Zhou, Chang Cai
Lung abscess results in a severe type of pneumonia, characterized by pulmonary suppurative infection [23]. Effective antibiotics and direct drainage are the ideal basic principles for the treatment of abscess diseases [24]. Depending on the pathogenesis of the lung abscess, the purulent cavity is often located in a place where drainage is difficult [2]. Therefore, simple postural drainage often insufficient to achieve effective drainage [3]. In such cases, PTD can achieve effective drainage. PTD of lung abscesses is often performed under CT or ultrasound localization [25]. The catheter is inserted into the purulent cavity under guidance, and then draws the pus out by means of negative pressure or direct suction [7]. The cavity is also regularly flushed with physiological saline [26]; if necessary, urokinase can also be used for such flushing [27]. Although CT-guidance was long considered the first choice for PTD [28], ultrasound localization has now been shown to have the same safety and effectiveness as CT, while doing less damage [29,30].
The pharmacological treatment of bronchiectasis
Published in Expert Review of Clinical Pharmacology, 2018
Andrea S Melani, Nicola Lanzarone, Paola Rottoli
ACTs promote the elimination of bronchial secretions. A Cochrane review evaluating different ACT interventions has shown that they are safe and assure significant, although small and highly variably, improvements in sputum expectoration, lung function and QoL [49]. ACTs include chest physiotherapy with breathing exercise and postural drainage alone or combined with manual or device-related percussion and vibration. Positive expiratory pressure devices, eventually with add-on oscillating systems, are also used to produce a constant back pressure to the airways during expiration, that favorites expectoration. Many different ACTs are available; no single type of ACT seems to be clearly superior to another, so their prescription varies in accordance to local practice, patient’s adherence and preference [49]. ACTs are time-consuming and can need for technical assistance. The BTS guideline suggests that at least postural drainage and forced expiratory technique, two rather basic ACTs, should be offered to bronchiectatic subjects with daily sputum or common exacerbations [9]. In the 2011 UK audit, almost 70% of subjects with bronchiectasis were referred to respiratory physiotherapists for delivery of ACTs [21]. Further studies should evaluate the long-term impact of ACTs on exacerbations and disease progression as well as the adherence to these treatments.