Pulmonary hygiene

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Pulmonary hygiene, also referred to as pulmonary toilet,

toiletry
that also relate to cleansing.

Respiratory health (pulmonary hygiene) depends on consistent clearance of airway secretions. Normal airway clearance is accomplished by two important mechanisms: the mucociliary clearance system and the ability to cough. Impaired mucociliary clearance is linked to poor lung function in a broad range of diseases and disabilities.[2]

Pulmonary hygiene prevents

chest trauma.[4]
Methods include using suction to remove fluids and placing the patient in a position that allows secretions to drain by gravity.

Methods

Methods used for pulmonary hygiene include

cilia of the airways to remove material. Positioning is another method for promoting drainage of secretions; sometimes patients are placed in a prone position to aid in this purpose.[4]

Conventional chest physiotherapy

The most common treatment of

physiotherapy
to learn to tip themselves into a position in which the lobe to be drained is uppermost at least three times daily for up to 30 minutes during each session.

The treatment is often used in conjunction with a technique for loosening secretions in the chest cavity called chest percussion. Chest percussion is performed by clapping the back or chest with a cupped hand. Alternatively, a mechanical vibrator may be used in some cases to facilitate loosening of secretions.[13] There are drainage positions for all segments of the lung. These positions are modified depending on the patient's condition and the location of the area in most need of therapy.

Intermittent positive pressure breathing (physiotherapy)

Main article: Intermittent positive pressure breathing

Intermittent positive pressure breathing (IPPB) physiotherapy has long been used in the intensive care setting in non-intubated patients. Although widely accepted, few studies have validated its efficacy. In a Respiratory Care Clinical Practice Guideline,[14] IPPB is suggested for patients who have impaired airway clearance, and for delivery of aerosolized medications to patients with neuromuscular weakness who are incapable of inhaling deeply. IPPB physiotherapy should be used with caution in patients with severe, uncontrolled bronchospasm or severe airway obstruction

Mechanical insufflation-exsufflation physiotherapy

People with neuromuscular weakness and atelectasis benefit from mechanical insufflation-exsufflation.

abdominal thrust during the expiratory phase (exhale). An American Thoracic Society consensus statement in 2004 supported the use of mechanical insufflation-exsufflation physiotherapy for patients with Duchenne muscular dystrophy.[17] The use of this technique for children with neuromuscular disease has gained widespread acceptance in the United States and internationally.[18][19]

Applications

Pulmonary bronchial hygiene is used for preventing infections such as

lung diseases, bronchial hygiene is used to prevent infections and lung abscesses.[20] Bronchial hygiene is also used to prevent acute respiratory distress syndrome after chest trauma.[4]

Indications

The need for bronchial hygiene is indicated in cases of

COPD, pneumonia and cystic fibrosis
as both interventional and prophylactic. Prophylactic indications also include pre and post thoracic surgery to prevent atelectasis and respiratory infections.

Contraindications

The decision to use postural drainage therapy requires assessment of potential benefits versus potential risks. Therapy should be provided for no longer than necessary to obtain the desired therapeutic results. Some of the contraindications include an increased intracranial pressure (>20 mmHg), any spinal injury acute or otherwise, active

congestive heart failure
and an open or healing wound in the area where chest physiotherapy is otherwise indicated.

Medication contraindications vary depending on the medication being delivered.

See also

References

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  6. ^ a b Virk A, Wilson WR (2001). "Tracheobronchitis and lower respiratory tract infections". In Wilson WR, Sande MA, Drew L (eds.). Current Diagnosis & Treatment in Infectious Diseases. New York: Lange Medical Books/McGraw-Hill. p. 145.
    ISBN 0-8385-1494-4
    . Retrieved 2008-06-30.
  7. ISBN 978-0-7817-7032-3
    . Retrieved 2008-06-30.
  8. ISBN 0-387-98393-7
    . Retrieved 2008-07-01. pulmonary toilet pulmonary physiotherapy.
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  12. Dorland's Medical Dictionary
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  13. ^ "Hypersensitivity Pneumonitis - Lung and Airway Disorders".
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  20. ^ Virk and Wilson, p. 153
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