Suctioning the airway involves an invasive procedure using a suction catheter inserted past the larynx to suction out secretions. This article will discuss the range of airway clearance therapy (ACT) options with a focus on devices, and discuss their applications and effectiveness for treatment of these respiratory diseases and the problem of secretions that cannot be cleared spontaneously.
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Obviously, there is a need for more studies to increase the body of scientific evidence on this topic.” 2ĪCT can be divided into breathing techniques (ie active cycle of breathing, autogenic drainage), manual techniques (postural drainage and manual percussion), and mechanical devices (ie PEP, OPEP/VPEP, HFCWO, IPV). This absence of evidence, however, does not necessarily mean an absence of efficacy.
1Ī recent 2021 publication about ACT points out a continuing problem concerning research on this topic: “Up to now, for all ACTs there is insufficient evidence to prove their efficacy and effectiveness in different clinical scenarios or to affirm the superiority of one technique over another.
Neuromuscular diseases such as Duchenne muscular dystrophy, amyotrophic lateral sclerosis, or spinal cord injury contribute to weak, ineffective, or absent cough and lead to retained secretions. Diseases such as cystic fibrosis, bronchiectasis, COPD, asthma, and pneumonia are linked to increased mucus production. Suction? Positive expiratory pressure? Percussion? Oscillation? Cough assist? With an array of airway clearance therapy options available for respiratory therapists, what device is the right tool for the specific job? Retained secretions create increased risk for infection, increases airway resistance and work of breathing, and can lead to consolidation, mucus plugging, atelectasis, V/Q mismatching and poor oxygenation. Suction? PEP? Percussion? Oscillation? Cough assist? With an array of airway clearance therapies available for respiratory therapists, how do RTs choose the right method for the job? BY Bill Pruitt, MBA, RRT, CPFT, AE-C, FAARC
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