Skip to main content

Table 4 Evidence summary

From: Benefits of interventions for respiratory secretion management in adult palliative care patients—a systematic review

Intervention Disease Critically relevant for clinical decision Relevant for Clinical Decision Less Relevant for Clinical Decision
Comfort Effectiveness Health related quality of life Survival Resting dyspnoea Hospital days Hospital admission Intervention duration Respiratory complications Tracheotomy prev/removal Cough Oxygenation Dyspnoea during exercise PCF FEV1 FVC Secretion Amount PaCO2, Ph Chest Tightness Airway Resistance PIMax PEMax
Mechanical insufflator-exsufflator COPD --- --- --- --- ↓ 3 --- --- --- --- --- --- ↑ 3 --- ↔ 3 --- --- --- --- --- --- --- ---
SCI --- --- --- --- --- --- ↔ 3 --- ↔ 3 --- --- ↔ 3 --- ↑ 3 ↑ 3 ↑ 3 --- ↔ 3 --- --- --- ---
NMD ↑ 1a ↑ 3 ↔ 2 ↑2 ↓ 3 ↔ 2 ↕ 2 ↓ 3 ↕2 ↑2 --- ↑ 3 --- ↑ 1a --- ↑3 --- --- --- --- --- ---
EMT MS --- ↑ 2 --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- ↕ 2 ↕ 2
MAC NMD ↑3 ↑ 2 --- --- --- --- --- --- --- --- --- --- --- ↑ 2 --- --- --- --- --- --- --- ↑3
PEP Mask COPD --- --- --- --- --- ↔ 2 --- --- ↔ 2 --- ↑ 2 ↔ 2 ↕ 2 --- ↔ 2 ↔ 2 ↔ 2 ↑ 2 --- --- --- ---
CF --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- ↓3 --- --- ---
FES SCI --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- ↑3
Percussive ventilation NMD --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- ↑ 2 --- --- ↔ 2 --- ---
Vibratory vest NMD --- --- --- ↔ 3 --- --- --- --- ↔ 3 --- --- --- --- --- --- ↔ 3 --- --- --- --- --- ---
Tracheotomy NMD --- --- --- ↑2 --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- ---
  1. OCEBM levels of evidence: 1- Systematic reviews / 2- Randomized controlled trials or observational studies with dramatic effect / 3: Non-randomized trials/follow-up studies
  2. PCF Peak cough flow, FEV 1 Forced expiratory volume in the first second, FVC Forced vital capacity, PaCO 2 Arterial pressure of carbon dioxide, PIMax Maximum inspiratory pressure, PEMax Maximum expiratory pressure, COPD Chronic obstructive pulmonary disease, SCI Spinal cord injury, NMD Neuromuscular disease, EMT Expiratory muscle training, MS Multiple sclerosis, MAC Manually assisted cough, PEP Positive expiratory pressure, CF Cystic fibrosis, FES Functional electrical stimulation; ↑: increase; ↓: decrease; ↕: conflicting results; ↔: No change. aConsidered the systematic review from Morrow and colleagues [46]