What’s new in airway secretions clearance for adults? A systematic review

Introduction. Airway clearance techniques are an essential part of routine respiratory physiotherapy, enabling bronchial secretion clearance—the mucus overproduction and retaining results in lung function deterioration and disrupts effective pulmonary rehabilitation. Several mucus clearance methods are included in the physiotherapy daily routine of patients with chronic lung conditions; nevertheless, new techniques and approaches are continuously developed. Aim. Thus, this systematic review summarizes novel airway clearance techniques applied in patients with chronic pulmonary conditions. Material and methods. The PubMed, Cochrane Library, and PEDro databases were searched from 2010 to 2021, and studies were selected based on eligibility criteria. Analysis of the literature. 101 patients from five studies describing four different techniques were included. Novel techniques were non-invasive ventilation, intrapulmonary percussive ventilation, trachea vibration, and PEP-sound wave combination. Significant improvements were noted for ventilation homogeneity (NIV), saturation (NIV), respiratory rate (IPV), and diffusion capacity (VL), whereas cardiovascular function and exercise endurance did not change significantly. Conclusion. The presented methods are considered to have similar effectiveness as well-known airway clearance techniques. However, the systematic use of presented methods in routine pulmonary rehabilitation must be preceded by in-depth investigation to provide no-bias results.