Airway clearance in the spontaneously breathing adult – the evidence

Abstract

Cardiorespiratory physiotherapy is no longer synonymous with airway clearance; however, in broadening skills and expertise, especially into rehabilitation, the pendulum has swung too far, and airway clearance is not always used when indicated. Clinical practice is influenced by clinical guidelines which are based on systematic reviews, and in the absence of systematic reviews, on single randomised controlled trials and even single quasi-experimental trials. Systematic reviews invariably conclude that there is little evidence to support a particular technique, which is no surprise as many early cardiorespiratory physiotherapy studies did not use the randomised controlled trial method. This paper looks at the evidence which is available for airway clearance, and emphasises the need for more randomised controlled trials in this field.

Keywords:

• AIRWAY CLEARANCE
• SYSTEMATIC REVIEWS