Adjunctive Respiratory Therapy In The ICU

Abstract

Most critically ill patients are unable to effectively clear secretions that accumulate in the central and peripheral airways. this can be due to factors such as:Increased secretion production, impaired cough reflex, weakness and pain. Adjunctive respiratoey therapy addresses many of these concerns to prevent and treat respiratory complications that are encountered in the critically ill patient through several methods. There are several methods to improve pulmonary mucocilliary clearance as Percussion of the chest that can aid in secretion clearance. It is performed by clappingcupped hands over regions of the thorax that are affected in a rhythmic fashion or using mechanical devies that mimic the same action,High-frequency chest compression (HFCC) relies on rapid pressure changes to the respiratory system during expiration to enhance movement of mucus in the peripheral airways to the central airways for clearance.this method employs a vest worn by the patient that is attached to an air pulse generator. It is difficult to apply this technique to most critically ill patients because the size of the vest covering the thorax may prevent adequate monitoring, Manual hyperinflationaims to recruit atelectatic lung regions to improve oxygenation and improve clearance of secretions, Positioning & mobilization of patients in the ICU either through active or passive limb exercises may improve overall patient well-being and in long term may lead to better patient outcomes and also play an important role, Tracheal suctioning is used in conjunction with other techniques to mobilize secretions from the peripheral airways to the central airway, suctioning is an effective way of removing secretions to improve bronchial hygiene and other several methods as rotational therapy, assisted coughing and bronchoscopy.