Benefits of interventions for respiratory secretion management in adult palliative care patients—a systematic review
| Autor: | Jenny Brine, Ebun Abarshi, Juliano Ferreira Arcuri, Nancy Preston, Valéria Amorim Pires Di Lorenzo |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Respiratory Therapy medicine.medical_specialty Palliative care Respiratory secretion medicine.medical_treatment Respiratory System Respiratory Tract Diseases Psychological intervention Chest physiotherapy law.invention Positive-Pressure Respiration 03 medical and health sciences 0302 clinical medicine Tracheotomy Randomized controlled trial law medicine Humans Intensive care medicine Physical Therapy Modalities Expectorants Randomized Controlled Trials as Topic Medicine(all) Cross-Over Studies business.industry Palliative Care Gold standard Sputum Insufflation General Medicine Observational Studies as Topic Cough 030228 respiratory system Patient Satisfaction Chronic Disease Breathing Observational study business 030217 neurology & neurosurgery Research Article |
| Zdroj: | BMC Palliative Care |
| ISSN: | 1472-684X |
| DOI: | 10.1186/s12904-016-0147-y |
| Popis: | Background Respiratory secretions impact negatively on palliative patients. Unfortunately, a gold standard therapy is not yet available. The purpose of this study was to identify which interventions are in use to control respiratory secretions in patients with chronic disease with a poor prognosis and verify their effects on outcomes relevant for palliative care patients. Methods A systematic review of the literature with narrative summary was conducted. We searched eight electronic databases in April 6th, 2016. Citation-tracking and reference list searches were conducted. We included randomized controlled trials, crossover trials, observational and qualitative studies regarding interventions for respiratory secretion management in adult patients with chronic diseases that met inclusion criteria indicating short prognosis. Results Six randomized controlled trials, 11 observational studies, ten crossover trials and one qualitative study were found. Interventions included mechanical insufflation-exsufflation (MIE), expiratory muscle training, manually-assisted cough, tracheotomy, chest physiotherapy, suctioning, air stacking, electrical stimulation of abdominal muscles, nebulized saline, positive expiratory pressure masks, percussive ventilation, high frequency chest wall oscillations. The interventions with most promising benefits to patients in palliative care were manually-assisted cough and mechanical insufflation-exsufflation to promote expectoration and percussive ventilation to improve mucous clearance. Conclusion Therapies, such as manually assisted cough, mechanical insufflation-exsufflation and percussive ventilation, which aim to deal with respiratory secretion, were the most promising treatment for use in palliative care for specific diseases. Nevertheless, the evidence still needs to improve in order to identify which treatment is the best. Electronic supplementary material The online version of this article (doi:10.1186/s12904-016-0147-y) contains supplementary material, which is available to authorized users. |
| Databáze: | OpenAIRE |
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