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Frankly, I think a lot of therapists think it stinks, and they don't recommend it because they don't want to deal with it. It is effective for debris mobilization: we've shown that. Every airway-clearance technique has benefits and risks that the clinician must be aware of. Da Silva et al found, in a study of 45 children < 1 year old, that adventitious breath sounds and sputum production had the highest positive predictive value for insufficient airway clearance.70 But does the presence of adventitious breath sounds indicate that the patient is getting worse? Ineffective airway clearance related to presence of mucus or amniotic fluid in airway. Caruso's 2009 study of 262 adult patients found a VAP risk reduction of 54% with routine saline instillation.61 A limitation of that study may be that HMEs were utilized to provide humidification, possibly necessitating saline instillation for secretion thinning. Risk for ineffective airway clearance r/t presence of mucus in mouth and nose at birth. Research supports the use of closed-system suctioning. What are some of the suggested interventions for this diagnosis? Plioplys et al104 found fewer pneumonias and respiratory-related hospitalizations in 7 quadriplegic cerebral palsy patients. If you do a recruitment maneuver with open suctioning, it's a little bit harder because you have to clamp the ETT to keep them at the maximum inspiration before reconnecting the ventilator. Interventions to restore natural balance should be the first step in any airway maintenance program; however, much more research is needed. Discomfort has been associated with suctioning in the adult population. What you're talking about is percussion and postural drainage, right? While most studies have focused on the primary outcome of sputum production, it is not clear whether sputum volume is an appropriate indication for or outcome of airway clearance. Re to: Adjustment to . But a multicenter randomized trial with 496 previously healthy hospitalized bronchiolitic patients found that that modified physiotherapy regimen (exhalation technique and assisted cough) did not significantly affect time to recovery107,108, A common chest radiograph finding in the postoperative patient is atelectasis, which is associated with morbidity. Ineffective Airway Clearance - Source of Resources for Nurses In that study, which was in adults, they theorized the opposite, that the lavage clears and prevents the biofilms. He's been a big friend of the ECMO [extracorporeal membrane oxygenation] community. Ineffective Breathing Pattern. We've been able to manipulate pH to some extent, having shown that alters either the rheology or the transportability of secretions. We don't really know if suctioning promotes or prevents VAP. We have little evidence on recruitment maneuvers in children. Ineffective Airway Clearance Nursing Diagnosis & Care Plan