Newer techniques of humidification and secretion clearance

Abstract

This paper begins with a review of airway anatomy, physiology of airway secretions, alterations in disease, and the importance of the mucociliary escalator, especially in airway disease states (asthma, COPD, cystic fibrosis, bronchiectasis etc). Alternatives to treating mild to moderate hypoxemia with high flow nasal cannula oxygen (HFNCO) such as Vapotherm are mentioned. A relatively new technique called Intrapulmonary Percussive Ventilation (IPV®) seems very effective in secretion removal. A newer device called CoughAssist™ assists cough by mechanical insufflation-exsufflation and is very useful in neurological disease. The review then focuses on High Frequency Percussive Ventilation (HFPV), otherwise known as Volumetric Diffusive Ventilation (VDR®). Lastly, the use of biphasic cuirass ventilation for secretion removal has been described.