Ineffective cough and mechanical mucociliary clearance techniques

Med Intensiva (Engl Ed). 2018 Jan-Feb;42(1):50-59. doi: 10.1016/j.medin.2017.05.003. Epub 2017 Jun 12.
[Article in English, Spanish]

Abstract

Cough is a fundamental defense mechanism for keeping the airway free of foreign elements. Life-threatening situations may arise when cough proves ineffective as a result of muscle weakness or altered mucociliary function. When a patient is unable to cough effectively, techniques are required to either reinforce or replace cough capacity. The use of mechanical systems that facilitate or substitute cough function is increasingly common in Intensive Care Units, where it is relatively frequent to find situations of ineffective cough due to different clinical causes. This review examines the current clinical practice recommendations referred to the indication and use of mechanical cough assist and intrapulmonary percussive ventilation systems.

Keywords: Aclaramiento mucociliar; Cough assist; Intrapulmonary percussive ventilation; Mucociliary clearance; Tos asistida; Tos mecánica; Ventilación percutora intrapulmonar.

Publication types

  • Review

MeSH terms

  • Airway Obstruction / etiology
  • Airway Obstruction / prevention & control*
  • Airway Obstruction / therapy
  • Cough* / physiopathology
  • Humans
  • Intensive Care Units
  • Mucociliary Clearance* / physiology
  • Muscle Weakness / complications
  • Percussion
  • Respiration, Artificial
  • Respiratory Function Tests
  • Respiratory Paralysis / complications
  • Respiratory Therapy / adverse effects
  • Respiratory Therapy / instrumentation
  • Respiratory Therapy / methods*
  • Tracheotomy