Clinical review: airway hygiene in the intensive care unit.
Maintenance of airway secretion clearance, or airway hygiene, is important for the preservation of airway patency and the prevention of respiratory tract infection. Impaired airway clearance often prompts admission to the intensive care unit (ICU) and can be a cause and/or contributor to acute respiratory failure. Physical methods to augment airway clearance are often used in the ICU but few are substantiated by clinical data. This review focuses on the impact of oral hygiene, tracheal suctioning, bronchoscopy, mucus-controlling agents, and kinetic therapy on the incidence of hospital-acquired respiratory infections, length of stay in the hospital and the ICU, and mortality in critically ill patients. Available data are distilled into recommendations for the maintenance of airway hygiene in ICU patients.
Jelic
Sanja
S
Division of Pulmonary, Allergy, and Critical Care Medicine, Columbia University College of Physicians and Surgeons, 630 West 168th Street, New York, NY 10032, USA. sj366@columbia.edu
Cunningham
Jennifer A
JA
Factor
Phillip
P
D000890:Anti-Infective Agents / Q000627:therapeutic use; D001999:Bronchoscopy; D003428:Cross Infection / Q000517:prevention & control*; D003666:Decontamination / Q000379:methods; D005100:Expectorants / Q000627:therapeutic use; D017052:Hospital Mortality; D006801:Humans; D006920:Hygiene / Q000592:standards*; D007362:Intensive Care Units; D007902:Length of Stay / Q000706:statistics & numerical data; D020545:Respiratory Mucosa / Q000378:metabolism*; D012141:Respiratory Tract Infections / Q000517:prevention & control*; D012307:Risk Factors; D013396:Suction
D000890:Anti-Infective Agents; D005100:Expectorants