Improving mucociliary clearance in chronic obstructive pulmonary disease

被引:62
作者
Bhowmik, Angshu [1 ]
Chahal, Kamaljeet [2 ]
Austin, Gillian [2 ]
Chakravorty, Indranil [2 ,3 ]
机构
[1] Homerton Univ Hosp, NHS Fdn Trust, Dept Resp Med, London, England
[2] Lister Hosp, Dept Resp Med, Stevenage, Herts, England
[3] Univ Hertfordshire, Beds & Herts Postgrad Med Sch, Hatfield, Herts, England
关键词
COPD; High frequency chest wall oscillation; Physiotherapy; Exacerbations; TRACHEAL MUCUS CLEARANCE; CHEST-WALL OSCILLATION; AIRWAY BACTERIAL LOAD; HYPERTONIC SALINE; CYSTIC-FIBROSIS; SPUTUM EXPECTORATION; EXPIRATORY PRESSURE; CHRONIC-BRONCHITIS; FREQUENCY; PHYSIOTHERAPY;
D O I
10.1016/j.rmed.2008.10.014
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Patients with COPD usually experience mucus hypersecretion as a result of airway inflammation and response to noxious stimuli. These in turn lead to worsening airway resistance, impaired airflow, increased work of breathing, dyspnoea and exercise intolerance. Mucus hypersecretion may also Lead to increased exacerbations and poor health related quality of Life (HRQL). Institution based pulmonary rehabilitation programs incorporating airway clearance techniques have been shown to improve HRQL, reduce dyspnoea and improve exercise tolerance but are often difficult to provide due to restricted accessibility and resource implications. This review examines the current evidence base and best clinical practice in the area of airway clearance. Mechanical devices such as the flutter valves, positive end expiratory pressure and high frequency chest watt oscillation (HFCWO) may be able to provide the benefits of improved airway clearance in the patient's home potentially with reduced demands on healthcare resources. (c) 2008 Elsevier Ltd. All rights reserved.
引用
收藏
页码:496 / 502
页数:7
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