Skip to main content
SpringerLink
Log in
Book cover

Paediatric Respiratory Care pp 67–104Cite as

Chest Physiotherapy Techniques and Adjuncts to Chest Physiotherapy

  • Chapter

  • 203 Accesses

Abstract

In normal health mucus produced by the tracheobronchial tree is continually propelled upstream by cilial action toward the upper respiratory tract, from where it can be expectorated or swallowed, thus maintaining a clear and patent airway. Respiratory pathology may alter this process in different ways. Tracheobronchial secretions may increase in quantity, change in consistency or there may be a disruption of the normal mucociliary clearance process due to direct cilial damage. Under these circumstances a variety of chest physiotherapy techniques may be employed to enhance tracheobronchial clearance. In addition respiratory physiotherapy can reduce the work of breathing, improve oxygenation, may help to maintain lung volume and improve exercise tolerance. Functional and postural re-education are also important elements of chest physiotherapy.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Agostini, E. and Hyatt, R.E. (1986) Static behavior of the respiratory system, in American Physiological Society Handbook of Physiology — The Respiratory System, Williams and Wilkins, Baltimore.

    Google Scholar 

  • Ali, J., Serrette, C., Wood, L.D.H. et al., (1984) The effect of postoperative positive pressure breathing on lung function. Chest, 85, 192–6.

    Article  PubMed  CAS  Google Scholar 

  • Allen, D. (1988) Making sense of suctioning. Nursing Times, 84, 46–7.

    PubMed  CAS  Google Scholar 

  • Alpan, G., Glick, B., Peleg, O. et al. (1984) Pneumothorax due to endotracheal tube suction. American Journal of Perinatology, 1, 345–8.

    Article  PubMed  CAS  Google Scholar 

  • Andersen, J.B., Qvist, J. and Kann, T. (1979) Recruiting collapsed lung through collateral channels with positive end expiratory pressure. Scandanavian journal of Respiratory Disease, 60, 260–6.

    CAS  Google Scholar 

  • Anderson, K. and Chandra, K. (1976) Pneumothorax secondary to perforation of sequential bronchi by suction catheters. Journal of Paedi-atric Surgery, 11, 687–93.

    Article  CAS  Google Scholar 

  • Bateman, J.R.M., Newman, S.P., Daunt, K.M. et al. (1979) Regional lung clearance of excessive bronchial secretions during chest physiotherapy in patients with stable chronic airways obstruction. Lancet, 1, 294–7.

    Article  PubMed  CAS  Google Scholar 

  • Bateman, J.R.M., Newman, S., Daunt, K.M. et al. (1981) Is cough as effective as chest physiotherapy in the removal of excessive tracheobronchial secretions? Thorax, 36, 683–7.

    Article  PubMed  CAS  Google Scholar 

  • Blodgett, D. (1980) Manual of Respiratory Care Procedures, J.B. Lippincott, Philadelphia, p. 517.

    Google Scholar 

  • Blumenthal, I. and Lealman, G.T. (1982) Effects of posture on gastro-oesophageal reflux in the newborn. Archives of Disease in Childhood, 57, 555–6.

    Article  PubMed  CAS  Google Scholar 

  • Bodai, B.I., Walton, C.B., Briggs, S. and Goldstein, M. (1987) A clinical evaluation of an oxygen insufflation/suction catheter. Heart Lung, 16, 39–46.

    PubMed  CAS  Google Scholar 

  • Bostick, J. and Wendelgass, S.T. (1987) Normal saline instillation as part of the suctioning procedure: Effects on PaO2 and amount of secretions. Heart Lung, 16, 532–7.

    PubMed  CAS  Google Scholar 

  • Bott, J., Keilty, S.E.J. and Noone, L. (1992) Intermittent positive pressure — a dying art? Physiotherapy, 78, 656–60.

    Article  Google Scholar 

  • Boutros, A.R. (1970) Arterial blood oxygenation during and after endotracheal suctioning in the apneic patient. Anesthesiology, 32, 114–18.

    Article  PubMed  CAS  Google Scholar 

  • Bowlby, J. (1953) Child Care and the Growth of Love, Penguin, Middlesex.

    Google Scholar 

  • Brackbill, Y., Douthitt, T.C. and West, H. (1973) Psychophysiologic effects in the neonate of prone versus supine placement. Journal of Pediatrics, 82, 82–3.

    Article  PubMed  CAS  Google Scholar 

  • Brain, J.D. (1980) Aerosol and humidity therapy. American Review of Respiratory Disease, 122, 17–21.

    PubMed  CAS  Google Scholar 

  • Brain, J.D. and Vallberg, P.A. (1979) State of the art deposition of aerosol in the respiratory tract. American Review of Respiratory Disease, 120, 1325–73.

    PubMed  CAS  Google Scholar 

  • Brandstater, B. and Muallen, M. (1969) Atelectasis following tracheal suctioning in infants. Anesthesiology, 31, 468–73.

    Article  PubMed  CAS  Google Scholar 

  • Brodsky, L., Reidy, M. and Stanievich, J. (1987) The effects of suction techniques on the distal tracheal mucosa in intubated low birth weight infants. International Journal of Pediatric Oto-rhinolaryngology, 14, 1.

    Article  CAS  Google Scholar 

  • Burton, J.D.K. (1962) Effects of dry anaesthetic gases on the respiratory membrane. Lancet, 1, 235–8.

    Article  PubMed  CAS  Google Scholar 

  • Byrne, I., Geary, M. and Crawford, B. (1990) Incentive spirometry — patient compliance. Physiotherapy Ireland, 8, 8–11.

    Google Scholar 

  • Campbell, A.H., O’Connell, J.M. and Wilson, F. (1975) The effect of chest physiotherapy upon FEV1 in chronic bronchitis. Medical Journal of Australia, 1, 33–5.

    PubMed  CAS  Google Scholar 

  • Campbell, T., Ferguson, N. and McKinlay, R.G.C. (1986) The use of a simple self-administered method of positive expiratory pressure (PEP) in chest physiotherapy after abdominal surgery. Physiotherapy, 72, 498–500.

    Google Scholar 

  • Chalon, L., Loew, D.A.Y. and Malebranche, J. (1972) Effects of dry anaesthetic gases on tracheobronchial ciliated epithelium. Anesthesiology, 37, 338–43.

    Article  PubMed  CAS  Google Scholar 

  • Choonara, I.A. (1989) Pain relief. Archives of Disease in Childhood, 64, 1101–2.

    Article  PubMed  CAS  Google Scholar 

  • Chuley, M. (1988a) Arterial blood gas changes with a hyperinflation and hyperoxygenation suctioning intervention in critically ill patients. Heart Lung, 17, 654.

    Google Scholar 

  • Chuley, M. (1988b) Efficacy of a hyperinflation and hyperoxygenation suctioning intervention. Heart Lung, 17, 15.

    Google Scholar 

  • Clayton, D.G., Webb, R.K., Ralston, A.C. et al. (1991) Pulse oximeter probes: a comparison between finger, nose, ear and forehead probes under conditions of poor perfusion. Anaesthesia, 46, 260–5.

    Article  PubMed  CAS  Google Scholar 

  • Clement, A.J. and Hubsch, S.K. (1968) Chest physiotherapy by the ‘bag squeezing’ method. Physiotherapy, 54, 355–9.

    PubMed  CAS  Google Scholar 

  • Connors, A.F., Hammon, W.E., Martin, R.J. et al. (1980) Chest physical therapy. The immediate effect on oxygenation in acutely ill patients. Chest, 78, 559–64.

    Article  PubMed  Google Scholar 

  • Conway, J.H. (1992) The effects of humidification for patients with chronic airways disease. Physiotherapy, 78, 97–101.

    Article  Google Scholar 

  • Cordero, L. and Hon, E.H. (1971) Neonatal bradycardia following nasopharyngeal stimulation. Journal of Pediatrics, 78, 441–7.

    Article  PubMed  Google Scholar 

  • Crabtree Goodnough, S.K. (1985) The effects of oxygen and hyperinflation on arterial oxygen tension after endotracheal suction. Heart Lung, 14, 11–17.

    Google Scholar 

  • Crane, L.D., Zombek, M., Krauss, A.N. and Auld, P.A.M. (1978) Comparison of chest physiotherapy techniques in infants with HMD. Pediatric Research, 12, 559.

    Article  Google Scholar 

  • Curran, C.L. and Kachoyeanos, M.K. (1979) The effects on neonates of two methods of chest physical therapy. American journal of Maternal and Child Nursing, 4, 309–13.

    Article  CAS  Google Scholar 

  • Czarnik, R.E., Stone, K.S., Everhart, C.C. and Preusser, B.A. (1991) Differential effects of continuous versus intermittent suction on tracheal tissue. Heart Lung, 20, 144–51.

    PubMed  CAS  Google Scholar 

  • Davies, H., Kitchman, R., Gordon, I. and Helms, P. (1985) Regional ventilation in infancy. New England Journal of Medicine, 313, 1626–8.

    Article  PubMed  CAS  Google Scholar 

  • DeCesare, J.A., Babchyck, B.M., Colten, H.R. and Treves, S. (1982) Radionuclide assessment of the effects of chest physical therapy on ventilation in cystic fibrosis. Physical Therapy, 62, 820–5.

    PubMed  CAS  Google Scholar 

  • Dehaven, C.B., Hurst, J.M. and Branson, R.D. (1985) Post extubation hypoxaemia treated with continuous positive airways pressure. Critical Care Medicine, 13, 46–8.

    Article  PubMed  Google Scholar 

  • Demers, R.S. and Saklad, M. (1973) Minimising the harmful effects of mechanical aspiration. Heart Lung, 2, 542.

    PubMed  CAS  Google Scholar 

  • Drew, J.H., Padoms, K. and Clabburn, S.L. (1986) Endotracheal tube management in newborn infants with hyaline membrane disease. Australian Journal of Physiotherapy, 32, 3–5.

    Google Scholar 

  • Durand, M., Sangha, B., Cabal, L.A. et al. (1989) Cardiopulmonary and intracranial pressure changes related to endotracheal suctioning in preterm infants. Critical Care Medicine, 17, 506–10.

    Article  PubMed  CAS  Google Scholar 

  • Emmanuel, G.E., Smith, W.M. and Briscoe, W.A. (1966) The effects of intermittent positive pressure breathing and voluntary hyperventilation upon the distribution of ventilation and pulmonary blood flow to the lung in chronic obstructive lung disease. Journal of Clinical Investigation, 45, 1221–33.

    Article  PubMed  CAS  Google Scholar 

  • Etches, P.C. and Scott, B. (1978) Chest physiotherapy in the newborn; effect on secretions removed. Pediatrics, 62, 713–15.

    PubMed  CAS  Google Scholar 

  • Feldman, F., Kanter, M.J., Robertson, C.S. et al. (1992) Effect of head elevation on intracranial pressure and cerebral blood flow in head injured patients. Journal of Neurosurgery, 76, 207–11.

    Article  PubMed  CAS  Google Scholar 

  • Fewell, J., Arrington, R. and Seibert, J. (1979) The effect of head position and angle of tracheal bifurcation on bronchus catheterisation in the intubated neonate. Pediatrics, 64, 318–20.

    PubMed  CAS  Google Scholar 

  • Finer, N.N. and Boyd, J. (1978) Chest physiotherapy in the neonate: a controlled study. Paediatrics, 61, 682–5.

    Google Scholar 

  • Finer, N.N., Moriarty, R.R., Boyd, J. et al. (1979) Postextubation atelectasis: a retrospective review and a prospective controlled study. Journal of Pediatrics, 94, 110–13.

    Article  PubMed  CAS  Google Scholar 

  • Fisk, G.C. and Baker, W.C. (1975) Mucosal changes in the trachea and bronchi of newborn infants after nasotracheal intubation. Anaesthesia and Intensive Care and Equipment, 3, 209–17.

    CAS  Google Scholar 

  • Fox, W.W., Berman, L.S., Dinwiddie, R. et al. (1977) Tracheal extubation of the neonate at 2 to 3 cm H2O continuous positive airways pressure. Pediatrics, 59, 257–61.

    PubMed  CAS  Google Scholar 

  • Gallon, A. (1992) The use of percussion. Physiotherapy, 78, 85–9.

    Article  Google Scholar 

  • Garrad, J. and Bullock, M. (1986) The effect of respiratory therapy on intracranial pressure in ventilated neurosurgical patients. Australian Journal of Physiotherapy, 32, 107–11.

    Google Scholar 

  • Gold, M., Duarte, I. and Muravchick, S. (1981) Arterial oxygenation in conscious patients after five minutes and after 30 seconds of oxygen breathing. Anesthetic Analogues, 60, 313.

    CAS  Google Scholar 

  • Gormezano, J. and Branthwaite, M.A. (1972a) Effects of physiotherapy during intermittent positive pressure ventilation. Anaesthesia, 27, 258–63.

    Article  PubMed  CAS  Google Scholar 

  • Gormezano, J. and Branthwaite, M.A. (1972b) Pulmonary physiotherapy with assisted ventilation. Anaesthesia, 27, 250–7.

    Google Scholar 

  • Graff, M., France, J., Hiatt, M. and Hegyi, T. (1987) Prevention of hypoxia and hyperoxia during endotracheal suctioning. Critical Care Medicine, 15, 1133–5.

    Article  PubMed  CAS  Google Scholar 

  • Gregory, G.A., Kitterman, J.A., Phibbs, R.H. et al. (1971) Treatment of the ideopathic respiratory distress syndrome with continuous positive airways pressure. New England Journal of Medicine, 284, 1333–40.

    Article  PubMed  CAS  Google Scholar 

  • Hanley, M.V., Rudd, T. and Butler, J. (1978) What happens to intratracheal saline instillations? American Review of Respiratory Disease, 117, 124.

    Google Scholar 

  • Heaf, D.P., Helms, P., Gordon, I. and Turner, H.M. (1983) Postural effects on gas exchange in infants. New England Journal of Medicine, 308, 1505–8.

    Article  PubMed  CAS  Google Scholar 

  • Hirsch, S.R., Zastrow, J.E. and Kory, R.C. (1969) Sputum liquifying agents: a comparative in vitro evaluation. Journal of Laboratory and Clinical Medicine, 74, 346–53.

    PubMed  CAS  Google Scholar 

  • Hodson, M.E., Penketh, A.R.L. and Batten, J.C. (1981) Aerosol cabenicillin and gentamicin treatment for Pseudomonas aeroginosa infection in cystic fibrosis. Lancet, 2, 1137–9.

    Article  PubMed  CAS  Google Scholar 

  • Holloway, R., Adams, E.B., Desai, S.D. et al (1969) Effect of chest physiotherapy on blood gases of neonates treated with intermittent positive pressure respiration. Thorax, 24, 421–6.

    Article  PubMed  CAS  Google Scholar 

  • Hussey, J.M. (1991) The relationship between specific chest physiotherapy techniques and oxygen saturation post paediatric cardiac surgery. MSc Thesis, University of London.

    Google Scholar 

  • Hussey, J.M., Hayward, L.J. and Andrews, M. (1992) The effect of chest physiotherapy techniques on oxygen saturation in children post cardiac surgery. Care of the Critically Ill, 8, 35.

    Google Scholar 

  • Ibanez, J., Raurich, M., Abizanda, R. et al (1981) The effect of lateral positions on gas exchange in patients with unilateral lung disease during mechanical ventilation. Intensive Care Medicine, 7, 321–4.

    Article  Google Scholar 

  • Imle, P.C. (1989) Percussion and vibration, in Chest Physiotherapy in the Intensive Care Unit, 2nd edn, (eds C.F. Mackenzie, P.C. Imle and N. Ciesla), Williams and Wilkins, Baltimore, pp. 134–52.

    Google Scholar 

  • Imle, P.C. and Klemic, N. (1991) Methods of airway clearance: coughing and suctioning, in Chest Physiotherapy in the Intensive Care Unit, 2nd edn, (eds C.F. Mackenzie, P.C. Imle and N. Ciesla). Williams and Wilkins, Baltimore, pp. 153–87.

    Google Scholar 

  • Jenkins, S.C. and Soutar, S.A. (1986) A survey into the use of incentive spirometry following coronary artery bypass graft surgery. Physiotherapy, 72, 492–3.

    Google Scholar 

  • Jones, A.Y.M., Hutchinson, R.C. and Oh, T.E. (1992) Effects of bagging and percussion on total static compliance of the respiratory system. Physiotherapy, 78, 661–6.

    Article  Google Scholar 

  • Jung, R.C. and Gottlieb, L.S. (1976) Comparison of tracheobronchial suction catheters in humans. Chest, 69, 179–81.

    Article  PubMed  CAS  Google Scholar 

  • Jung, R.C. and Newman, J. (1982) Minimising hypoxia during endotracheal airway care. Heart Lung, 11, 208–12.

    PubMed  CAS  Google Scholar 

  • Keilty, S.E.J. and Bott, J. (1992) Continuous positive airways pressure. Physiotherapy, 78, 90–2.

    Article  Google Scholar 

  • Kelly, R., Yao, F. and Artusio, J. (1987) Prevention of suction induced hypoxaemia by simultaneous oxygen insufflation. Critical Care Medicine, 15, 874.

    Article  PubMed  CAS  Google Scholar 

  • Kerem, E., Yatsiv, I. and Goitein, K.J. (1990) Effect of endotracheal suctioning on arterial blood gases in children. Intensive Care Medicine, 16, 95–9.

    Article  PubMed  CAS  Google Scholar 

  • Kigin, C.M. (1981) Chest physical therapy for the acutely ill medical patient. Physical Therapy, 61, 1724–36.

    PubMed  CAS  Google Scholar 

  • Kigin, CM. (1984) Advances in chest physical therapy, in Current Advances in Respiratory Care, (ed. W.J. O’Donohue), American College of Chest Physicians, Park Ridge, pp. 37–71.

    Google Scholar 

  • Kiriloff, L.H., Owens, G.R., Rogers, R.M. et al (1985) Does chest physical therapy work? Chest, 88, 436–44.

    Article  Google Scholar 

  • Kleiber, C., Krutzfield, N. and Rose, E.F. (1988) Acute histological changes in the tracheobronchial tree associated with different suction catheter insertion techniques. Heart Lung, 17, 10–14.

    PubMed  CAS  Google Scholar 

  • Klein, P., Kemper, M., Weissman, C. et al. (1988) Attenuation of the haemodynamic response to chest physical therapy. Chest 93, 38–42.

    Article  PubMed  CAS  Google Scholar 

  • Kovnat, D.M., Rath, G.S., Anderson, W.M. and Snider, G.L. (1974) Maximal extent of visualisation of the bronchial tree by fibreoptic bronchoscopy. American Review of Respiratory Disease, 110, 88–90.

    PubMed  CAS  Google Scholar 

  • Kubota, Y., Magaribuchi, T., Toyoda, Y. et al. (1982) Selective bronchial suctioning in the adult using a curved tip catheter with a guidemark. Critical Care Medicine, 10, 767–9.

    Article  PubMed  CAS  Google Scholar 

  • Kuzenski, B. (1978) Effect of negative pressure in tracheobronchial trauma. Nursing Research, 27, 260.

    PubMed  CAS  Google Scholar 

  • Landa, J.F., Kwoka, M.A., Chapman, G.A. et al. (1973) Effects of suctioning on mucociliary transport. Chest, 77, 202–7.

    Article  Google Scholar 

  • Laws, A.K. and Mclntyre, R.W. (1969) Chest physiotherapy: a physiological assessment during intermittent positive pressure ventilation in respiratory failure. Canadian Anaesthetic Society Journal 16, 487–93.

    Article  CAS  Google Scholar 

  • Liftschitz, L.I. and Denning, C.R. (1970) Quantative interaction of water and cystic fibrosis sputum. American Review of Respiratory Diseases, 102, 456–8.

    Google Scholar 

  • Link, W.J., Spaeth, E.E., Wahle, W.M. et al. (1976) The influence of suction catheter tip design on tracheobronchial trauma and fluid aspiration efficiency. Anesthetic Analogues, 55, 290–7.

    CAS  Google Scholar 

  • Litt, M. (1970) Mucous rheology: relevance to mucociliary clearance. Archives of Internal Medicine, 126, 417–23.

    Article  PubMed  CAS  Google Scholar 

  • Mackenzie, C. and Shin, B. (1985) Cardiorespiratory function before and after physiotherapy in mechanically ventilated patients with post traumatic respiratory failure. Critical Care Medicine, 13, 483–6.

    Article  PubMed  CAS  Google Scholar 

  • Mackenzie, C., Shin, B. and McAsian, T.C. (1978) Chest physiotherapy; the effects on arterial oxygenation. Anaesthesia & Analgesia, 57, 28–30.

    CAS  Google Scholar 

  • Maloney, F.P., Fernandez, E. and Hudgel, D.W. (1981) Postural drainage effect after bronchial obstruction. Archives of Physical Mecicine Rehabilitation, 62, 452–5.

    CAS  Google Scholar 

  • Marfatia, S., Donahoe, P.K. and Hendren, W.H. (1975) Effect of dry and humidified gases on the respiratory epithelium in rabbits. Journal of Pediatric Surgery, 10, 583–92.

    Article  PubMed  CAS  Google Scholar 

  • Marini, J.J., Pierson, D.J. and Hudson, L.D. (1979) Acute lobar atelectasis: a prospective comparison of fibreoptic bronchoscopy and respiratory therapy. American Review of Respiratory Disease, 119, 971–8.

    PubMed  CAS  Google Scholar 

  • Martin, R.J., Herrel, N., Ruben, D. and Fanaroff, A. (1979) Effect of supine and prone positions on arterial oxygen tension in the preterm infant. Journal of Pediatrics, 63, 528–31.

    CAS  Google Scholar 

  • Marx, G.F., Steen, S.N., Arkins, R.E. et al. (1968) Endotracheal suction and death. New York State Journal of Medicine, 15, 565–6.

    Google Scholar 

  • Mellins, R.B. (1974) Pulmonary physiotherapy in the pediatric age group. American Review of Respiratory Disease, 110 (supplement 2), 137–42.

    PubMed  CAS  Google Scholar 

  • Milner, A.D. (1993) Asthma in the preschool child. Journal of Association of Chartered Physiotherapists in Respiratory Care, 22, 7–8.

    Google Scholar 

  • Morrison, M.L. (1979) Respiratory Intensive Care Nursing, 2nd edn, Little, Brown & Co, Boston, p. 32.

    Google Scholar 

  • Motley, H.L., Werko, L., Cournand, A. et al. (1947) Observations of the clinical use of intermittent positive pressure. Journal of Aviation Medicine, 18, 417.

    PubMed  CAS  Google Scholar 

  • Muller, N.L. and Bryan, A.C. (1979) Chest wall mechanics and respiratory muscles in infants. Pediatric Clinics of North America, 26, 503–16.

    PubMed  CAS  Google Scholar 

  • Nagaraj, H.S., Shott, R., Fellows, R. and Yacoub, U. (1980) Recurrent lobar atelectasis due to acquired bronchial stenosis in neonates. Journal of Pediatric Surgery, 15, 411–15.

    Article  PubMed  CAS  Google Scholar 

  • Naigow, D. and Powaser, M.M. (1977) The effect of different endotracheal suction procedures on arterial blood gases in a controlled experimental model. Heart Lung, 6, 808–16.

    PubMed  CAS  Google Scholar 

  • Newhouse, M.T. and Rossman, C.M. (1984) Effect of chest physiotherapy on the removal of mucus in patients with cystic fibrosis. American Review of Respiratory Disease, 127, 391.

    Google Scholar 

  • Oberwaldner, B., Evans, J.C. and Zach, M.S. (1986) Forced expirations against a variable resistance: a new chest physiotherapy method in cystic fibrosis. Pediatric Pulmonology, 2, 358–67.

    Article  PubMed  CAS  Google Scholar 

  • O’Callghan, C., Milner, A. and Swarbrick, A. (1986) Paradoxical deterioration in lung function after nebulized salbutamol in wheezy infants. Lancet, 2, 1424–5.

    Article  Google Scholar 

  • O’Callaghan, C., Milner, A. and Swarbrick, A. (1989) Paradoxical bronchospasm in wheezing infants after nebulised preservative-free isoosmolar ipratropium bromide. British Medical Journal, 299, 1433–4.

    Article  PubMed  Google Scholar 

  • O’Donnel, D.R., Prasad, S.A., Wilkinson, K. et al. (1993) Nonbronchoscopic bronchoalveolar lavage: identifying groups with higher risks of complications, in Proceedings of European Society of Paediatric Intensive Care, Madrid.

    Google Scholar 

  • Oldenburg, F.A., Dolovich, M.B., Montgomery, J.M. and Newhouse, M.T. (1979) Effects of postural drainage, exercise and cough on mucus clearance in chronic bronchitis. American Review of Respiratory Disease, 120, 739–45.

    PubMed  Google Scholar 

  • Oppenshaw, P., Edwards, S. and Helms, P. (1984) Changes in rib cage geometry during childhood. Thorax, 39, 624–7.

    Article  Google Scholar 

  • Paratz, J. (1992) Haemodynamic stability of the ventilated intensive care patient: a review. Australian Journal of Physiotherapy, 38, 167–72.

    Google Scholar 

  • Parker, A.E. (1985) Chest physiotherapy in the neonatal intensive care unit. Physiotherapy, 71, 63–5.

    Google Scholar 

  • Partridge, C., Pryor, J.A. and Webber, B.A. (1989) Characteristics of the forced expiration technique. Physiotherapy, 75, 193–4.

    Article  Google Scholar 

  • Pavia, D., Thompson, M. L. and Clarke, S.W. (1978) Enhanced clearance of secretions from the human lung after the administration of hypertonic saline aerosol. American Review of Respiratory Diseases, 117, 199–203.

    CAS  Google Scholar 

  • Perlman, J.M. and Volpe, J.J. (1983) Suctioning in the preterm infant: effects on cerebral blood flow velocity, intracranial pressure and arterial blood pressure. Pediatrics, 72, 329–34.

    PubMed  CAS  Google Scholar 

  • Piehl, M.A. and Brown, M.S. (1976) Use of extreme position changes in acute respiratory failure. Critical Care Medicine, 4, 13–15.

    Article  PubMed  CAS  Google Scholar 

  • Placzek, M. and Silverman, M. (1983) Selective placement of bronchial suction catheters in intubated neonates. Archives of Disease in Childhood, 58, 829–31.

    Article  PubMed  CAS  Google Scholar 

  • Pryor, J.A. and Webber, B.A. (1992) Physiotherapy for cystic fibrosis — which technique? Physiotherapy, 78, 105–8.

    Article  Google Scholar 

  • Ratjen, F., Wonne, R., Posselt, H.G. et al. (1990) A double-blind placebo controlled trial with oral ambroxol and N-acetylcysteine for mucolytic treatment in cystic fibrosis. European Journal of Pediatrics, 144, 374.

    Article  Google Scholar 

  • Reisman, J.J., Rivington-Law, B., Corey, M. et al. (1988) Role of conventional physiotherapy in cystic fibrosis. journal of Pediatrics, 113, 632–6.

    Article  PubMed  CAS  Google Scholar 

  • Rhodes, L.A. (1987) A pressure regulated ‘bagging’ device — a pilot study. South African Journal of Physiotherapy, 43, 117–20.

    Google Scholar 

  • Richards, J.H. (1974) Effect of the relative humidity on the rheologic properties of bronchial mucous. American Review of Respiratory Diseases, 109, 484–6.

    CAS  Google Scholar 

  • Rindfleisch, S. and Tyler, M. (1981) The effects of duration of endotracheal suctioning on arterial oxygenation in anaesthetised dogs. American Review of Respiratory Disease, 123, 19.

    Google Scholar 

  • Rosen, M. and Hillard, E.K. (1962) The effects of negative pressure during tracheal suction. Anesthetic Analogues, 41, 50–7.

    CAS  Google Scholar 

  • Rosenbluth, M. and Chernick, V. (1974) Influence of mist tent therapy on sputum viscosity and water content in cystic fibrosis. Archives of Disease in Childhood, 49, 606–9.

    Article  PubMed  CAS  Google Scholar 

  • Rowe, M.L., Weinberger, M. and Poole, C.A. (1973) An experimental study on the vibration in postoperative tracheobronchial clearance. Journal of Pediatric Surgery, 8, 735–8.

    Article  PubMed  CAS  Google Scholar 

  • Rux, M.I. and Powaser, M.M. (1979) Effect of apnea and the levels of negative pressure on the fall in arterial tension produced by endotracheal suctioning in dogs. American Review of Respiratory Disease, 119, 193.

    Google Scholar 

  • Sackner, M.A., Landa, J.F., Greeneltch, N. and Robinson, M.J. (1973) Pathogenesis and prevention of tracheobronchial damage with suction procedures. Chest, 64, 284–90.

    Article  PubMed  CAS  Google Scholar 

  • Scharf, S.M., Brown, R., Saunders, N. et al. (1980) Hemodynamic effects of positive pressure inflation. Journal of Applied Physiology, 49, 124–31.

    PubMed  CAS  Google Scholar 

  • Schwartz, F.C.M., Fenner, A. and Wolfsdorf, J. (1975) The influence of body position on pulmonary function in low birthweight babies. South African Medical Journal, 49, 79–84.

    PubMed  CAS  Google Scholar 

  • Selsby, D.S., (1989) Chest physiotherpay. British Medical Journal, 298, 541–2.

    Article  PubMed  CAS  Google Scholar 

  • Shelly, M.P., Lloyd, G.M. and Park, G.R. (1988) A review of the mechanisms and methods of humidification of inspired gases. Intensive Care, 14, 1–9.

    Article  CAS  Google Scholar 

  • Shim, C., Fernandez, R., Fine, N. and Williams, H. (1969) Cardiac arrhythmias resulting from tracheal suctioning. American International Medicine, 71, 1149–53.

    Article  CAS  Google Scholar 

  • Shumaker, H.B. and Hampton, L.J. (1951) Sudden death occurring immediately after operation in patients with cardiac disease, with particular reference to the role of aspiration through the endotracheal tube and extubation. Journal of Thoracic Surgery, 21, 48.

    Google Scholar 

  • Simbruner, G., Coradello, H., Fodor, et al. (1981) Effect of tracheal suction on oxygenation, circulation and lung mechanics in newborn infants. Archives of Disease in Childhood, 56, 326–30.

    Article  PubMed  CAS  Google Scholar 

  • Smith, C.M. and Anderson, S.D. (1989) Review: inhalation provocation tests using nonisotonic aerosols. Journal of Allergy and Clinical Immunology, 84, 781–90.

    Article  PubMed  CAS  Google Scholar 

  • Soong, W.J. and Hwang, B.T. (1991) Selective placement of bronchial suction catheters in intubated full term and premature neonates. Chung Hua I Hsueh Tsa Chih, 48, 45–8.

    PubMed  CAS  Google Scholar 

  • Southall, D.P. and Samuels, M.P. (1992) Reducing risks in the sudden infant death syndrome. British Medical Journal, 304, 265–60.

    Article  PubMed  CAS  Google Scholar 

  • Starke, I.D., Webber, B.A. and Branthwaite, M.A. (1979) IPPB and hypercapnoea in respiratory failure: the effect of different concentrations of inspired oxygen on arterial blood gas tensions. Anaesthesia, 34, 283–7.

    Article  PubMed  CAS  Google Scholar 

  • Stiller, K., Geake, T., Taylor, J. et al. (1990) Acute lobar atelectasis. A comparison of two chest physiotherapy regimes. Chest, 98, 1336–40.

    Article  PubMed  CAS  Google Scholar 

  • Stock, M.C., Downs, J.B. and Corkran, M.L. (1984) Pulmonary function before and after prolonged CPAP by mask. Critical Care Medicine, 12, 973–4.

    Article  PubMed  CAS  Google Scholar 

  • Stock, M.C., Downs, J.B., Gaver, P.K. et al. (1985) Prevention of postoperative pulmonary complications with CPAP, incentive spirometry and conservative therapy. Chest, 87, 151–7.

    Article  PubMed  CAS  Google Scholar 

  • Stone, K.S., Preusser, B.A., Groch, K.F. et al. (1991) The effect of lung hyperinflation and endotracheal suctioning on cardiopulmonary hemodynamics. Nursing Research, 40, 76–9.

    PubMed  CAS  Google Scholar 

  • Sukumalchantra, Y., Park, S.S. and Williams, M.H. (1965) The effect of intermittent positive pressure breathing (IPPB) in acute ventilatory failure. American Review of Respiratory Disease, 92, 885–93.

    PubMed  CAS  Google Scholar 

  • Sumner, E. (1990) Artificial ventilation of children, in The Diagnosis and Management of Paediatric Respiratory Disease, (ed. R. Dinwiddie), Churchill Livingstone, London, pp. 267–87.

    Google Scholar 

  • Sutton, P.P., Parker, R.A. and Webber, B.A. (1983) Assessment of the forced expiration technique, postural drainage and directed coughing in chest physiotherapy. European Journal of Respiratory Disease, 64, 62–8.

    CAS  Google Scholar 

  • Sutton, P.P., Lopez-Vidriero, M.T., Pavia, D. et al. (1985) Assessment of percussion, vibratory shaking and breathing exercises in chest physiotherapy. European Journal of Respiratory Disease, 66, 147–52.

    CAS  Google Scholar 

  • Sutton, P.P., Gemmell, H.G., Innes, N. et al. (1988) Use of nebulised saline and nebulised terbutaline as an adjunct to chest physiotherapy. Thorax, 43, 57–60.

    Article  PubMed  CAS  Google Scholar 

  • Tattersall, M. (1982) Should we humidify our anaesthetic gases? A review. Anaesthesia Points West, 15, 17–19.

    Google Scholar 

  • Taylor, P. and Waters, H. (1971) Arterial Oxygen tensions following endotracheal suctioning on IPPV. Anaesthesia, 26, 289.

    Article  PubMed  CAS  Google Scholar 

  • Thomson, M.L., Pavier, D., Jones, C.J. et al. (1975) No demonstrable effect of S-carboxymethylcysteine on clearance of secretions from the human lung. Thorax, 30, 669–73.

    Article  PubMed  CAS  Google Scholar 

  • Tolles, C.L. and Stone, K.S. (1990) National survey of neonatal endotracheal suctioning practices. Neonatal Network, 9, 7–14.

    PubMed  CAS  Google Scholar 

  • Torres, G., Lyons, H.A. and Emerson, P. (1960) The effects of intermittent positive pressure breathing on the interpulmonary distribution of inspired air. American Journal of Medicine, 29, 946–54.

    Article  PubMed  CAS  Google Scholar 

  • Tudehope, D.I. and Bagley, C. (1980) Techniques of physiotherapy in intubated babies with the respiratory distress syndrome. Australian Paediatric Journal, 16, 226–8.

    PubMed  CAS  Google Scholar 

  • Vaughan, R.S., Menke, J.A. and Giacoia, G.P. (1978) Pneumothorax: a complication of endotracheal tube suction. Journal of Pediatrics, 92, 633–4.

    Article  PubMed  CAS  Google Scholar 

  • Wagaman, M.J., Shutack, J.G., Moomjian, A.S. et al. (1979) Improved oxygenation and lung compliance with prone positioning in neonates. Journal of Pediatrics, 94, 787–91.

    Article  PubMed  CAS  Google Scholar 

  • Walsh, J.M., Vanderwarf, C., Hoscheit, D. et al. (1989) Unsuspected hemodynamic alterations during endotracheal suction. Chest, 95, 162–5.

    Article  PubMed  CAS  Google Scholar 

  • Webber, B.A. (1988) Adjuncts to physiotherapy, in The Brompton Hospital Guide to Chest Physiotherapy, 5th edn (ed. B.A. Webber), Blackwell Scientific Publications, Oxford, pp. 120–45.

    Google Scholar 

  • Weiler, P.H., Ingram, D., Preece, M.A. and Matthew, D.J. (1980) Controlled trial of intermittent aerosol therapy with sodium 2-mercaptoethane sulphonate in cystic fibrosis. Thorax, 35, 42–6.

    Article  Google Scholar 

  • White, P.F., Schlobohm, R.M., Pitts, L.H. et al. (1982) A randomised study of drugs for preventing increases in intracranial pressure during endotracheal suction. Anesthesiology, 57, 242–4.

    Article  PubMed  CAS  Google Scholar 

  • Windsor, H.M., Harrison, G.A. and Nicholson, T.J. (1972) ‘Bag squeezing’, a physiotherapeutic technique. Medical Journal of Australia, 2, 829–32.

    PubMed  CAS  Google Scholar 

  • Winston, S.J., Gravelyn, T.R. and Sitrin, R.G. (1987) Prevention of bradycardic responses to endotracheal suctioning by prior administration of nebulized atropine. Critical Care Medicine, 15, 1009–11.

    Article  PubMed  CAS  Google Scholar 

  • Wollmer, P., Ursing, K., Midgren, B. and Eriksson, L. (1985) Inefficiency of chest percussion in the physical therapy of chronic bronchitis. European Journal of Respiratory Disease, 66, 233–9.

    CAS  Google Scholar 

  • Wong, J.W., Keens, T.G., Wannamaker, E.M. et al. (1977) Effects of gravity on tracheal transport rates in normal subjects and patients with cystic fibrosis. Pediatrics, 60, 146–52.

    PubMed  CAS  Google Scholar 

  • Young, C.S. (1984) Recommended guidelines for suction. Physiotherapy, 70, 106–8.

    PubMed  CAS  Google Scholar 

  • Young, C.S. (1988) Airway suctioning: a study of paediatric physiotherapy practice. Physiotherapy, 74, 13–16.

    Article  Google Scholar 

  • Zack, M.B., Pontoppidan, H. and Kazemi, H. (1974) The effect of lateral positions on gas exchange in pulmonary disease. American Review of Respiratory Disease, 110, 49–55.

    PubMed  CAS  Google Scholar 

  • Zausmer, E. (1968) Bronchial drainage, evidence supporting the procedures. Physical Therapy, 48, 586–91.

    PubMed  CAS  Google Scholar 

  • Zinman, R. (1984) Cough versus chest physiotherapy, a comparison of the acute effects on pulmonary function in patients with cystic fibrosis. American Review of Respiratory Disease, 129, 182–4.

    PubMed  Google Scholar 

Download references

Authors
  1. S. Ammani Prasad
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Juliette Hussey
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Respiratory Unit, Great Ormond Street Hospital for Children NHS Trust, London, UK

    S. Ammani Prasad (Superintendent Physiotherapist) (Superintendent Physiotherapist)

  2. School of Physiotherapy, Faculty of Health Sciences, Trinity College, Dublin, Republic of Ireland

    Juliette Hussey (Lecturer in Physiotherapy) (Lecturer in Physiotherapy)

Rights and permissions

Reprints and permissions

Copyright information

© 1995 Springer Science+Business Media Dordrecht

About this chapter

Cite this chapter

Prasad, S.A., Hussey, J. (1995). Chest Physiotherapy Techniques and Adjuncts to Chest Physiotherapy. In: Prasad, S.A., Hussey, J., Campling, J. (eds) Paediatric Respiratory Care. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-4469-6_6

Download citation

  • DOI: https://doi.org/10.1007/978-1-4899-4469-6_6

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-0-412-55000-3

  • Online ISBN: 978-1-4899-4469-6

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation