The efficacy of minitracheostomy for the management of sputum retention: a systematic review.
Suction via a mini-tracheostomy (MT) is a safe procedure, but its efﬁcacy in facilitating sputum clearance in individuals with an acute condition has not been systematically reviewed.
This study aimed to identify and synthesise the efﬁcacy of the insertion of a MT and tracheal suction via MT for sputum clearance in adults who have undergone surgery or have an acute condition characterised by sputum retention. A systematic literature search using the electronic databases with limited to English language journal articles published between 1984 and September 2011.
All study designs were included. Two independent reviewers used pre-deﬁned inclusion and exclusion criteria to identify all eligible articles.
Six studies in six patient groups met the inclusion criteria, with two randomised controlled trials and four case series included. These studies presented the results of 278 patients following surgery and 13 with acute medical conditions.
There were a range of criteria that deﬁned the efﬁcacy of MT for sputum retention. Studies reporting the adjunctive role found a reduced incidence of complications associated with sputum retention following thoracic surgery. Other studies reported limited beneﬁt in overall respiratory status with MT.
Limited evidence suggests that MT may be a useful adjunct in optimising sputum clearance in adults following thoracic surgery, but the effects in adults with an acute condition and other types of surgery are inconclusive. > From: Beach et al., Physiotherapy (2013) (Epub ahead of print). All rights reserved to The Chartered Society of Physiotherapy.
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