Abstract
BackgroundRespiratory secretions impact negatively on palliative patients. Unfortunately, a gold standard therapy is not yet available. The purpose of this study was to identify which interventions are in use to control respiratory secretions in patients with chronic disease with a poor prognosis and verify their effects on outcomes relevant for palliative care patients.MethodsA systematic review of the literature with narrative summary was conducted. We searched eight electronic databases in April 6th, 2016. Citation-tracking and reference list searches were conducted. We included randomized controlled trials, crossover trials, observational and qualitative studies regarding interventions for respiratory secretion management in adult patients with chronic diseases that met inclusion criteria indicating short prognosis.ResultsSix randomized controlled trials, 11 observational studies, ten crossover trials and one qualitative study were found. Interventions included mechanical insufflation-exsufflation (MIE), expiratory muscle training, manually-assisted cough, tracheotomy, chest physiotherapy, suctioning, air stacking, electrical stimulation of abdominal muscles, nebulized saline, positive expiratory pressure masks, percussive ventilation, high frequency chest wall oscillations. The interventions with most promising benefits to patients in palliative care were manually-assisted cough and mechanical insufflation-exsufflation to promote expectoration and percussive ventilation to improve mucous clearance.ConclusionTherapies, such as manually assisted cough, mechanical insufflation-exsufflation and percussive ventilation, which aim to deal with respiratory secretion, were the most promising treatment for use in palliative care for specific diseases. Nevertheless, the evidence still needs to improve in order to identify which treatment is the best.Electronic supplementary materialThe online version of this article (doi:10.1186/s12904-016-0147-y) contains supplementary material, which is available to authorized users.
Highlights
Respiratory secretions impact negatively on palliative patients
Most of Arcuri et al BMC Palliative Care (2016) 15:74 the diseases associated with the presence of respiratory secretion are chronic conditions and they may be lifethreatening in their later stages, which is an indication for palliative care
Studies were excluded when they were duplicates or clearly did not meet the inclusion criteria (Table 1) 3) The abstracts of these studies were read and retained where the content was relevant to the topic under consideration (JFA and JB) with disagreements resolved by a third reviewer (VAPDL) 4) The full papers were read by two independent reviewers (JFA and EA) to verify the inclusion criteria 5) A citation track and a reference search of included studies was performed (JB) 6) Data extraction was performed by two independent reviewers (JFA and EA) 7) The assessment of the methodological quality of the studies was done by two independent reviewers (JFA and VAPDL) using the PEDro scale, a 11-item scale, which ten are included in
Summary
Respiratory secretions impact negatively on palliative patients. The purpose of this study was to identify which interventions are in use to control respiratory secretions in patients with chronic disease with a poor prognosis and verify their effects on outcomes relevant for palliative care patients. The increased production of respiratory mucus is common in patients with cardiorespiratory [2] diseases and lung, head and neck cancer. Sometimes these conditions are associated with cough inefficiency due to muscle weakness and poor coordination [3, 4]. Most of Arcuri et al BMC Palliative Care (2016) 15:74 the diseases associated with the presence of respiratory secretion are chronic conditions and they may be lifethreatening in their later stages, which is an indication for palliative care
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
