Efectividad de las técnicas instrumentales oscilatorias de desobstrucción bronquial en el tratamiento de la Enfermedad Pulmonar Obstructiva Crónica, una revisión sistemática (Effectiveness of oscillatory instrumental bronchial clearance techniques in the treatment of Chronic Obstructive Pulmonary Disease, a systematic review)
DOI:
https://doi.org/10.47197/retos.v60.106983Palabras clave:
EPOC, limpieza mucociliar, oscilaciones de la pared del tórax, terapia respiratoria.Resumen
Introducción. Las técnicas de desobstrucción bronquial en donde se emplean dispositivos instrumentales oscilatorios utilizadas en el abordaje del paciente con EPOC pueden mejorar el patrón de tos y favorecer el flujo espiratorio, facilitando así la expulsión de las secreciones, evitar atelectasias, favorecer la mecánica ventilatoria, la oxigenación y el mantenimiento de la vía aérea permeable. Métodos: Se realizó una revisión sistemática siguiendo los criterios de inclusión a partir de búsqueda de bases de datos electrónicas como: PubMed, Science Direct, Scopus, Springer, Google Académico, entre el periodo 01/05/2023 al 01/02/2024 en idioma inglés, español y portugués incluyendo estudios tipo Ensayos Clínicos Aleatorizados y estudios de cohortes. Resultados: En total 14 artículos fueron incluidos, 100% en idioma inglés. El número de participantes fue de 3105, con edades entre 35 y 85 años, 50,2% de los participantes fueron mujeres. Oscilación Oral de Alta Frecuencia (HFCWO®) fue el dispositivo más usado 35,7% n=5, seguido de Flutter® 28,6% n=4. El tiempo de intervención osciló entre 1 a 12 semanas, de 3 a 7 veces por semana, entre 1 a 4 sesiones diarias, con duración entre 10 a 30 minutos, entre 10 a 20 Hz. Conclusiones: El uso de HFCWO puede tener un impacto positivo en la rehabilitación pulmonar, específicamente en las variables de función pulmonar y oxigenación, cuando se implementa como terapia complementaria a la movilización temprana, el ejercicio terapéutico y a las técnicas respiratorias de desobstrucción bronquial.
Palabras claves: EPOC, limpieza mucociliar, oscilaciones de la pared del tórax, terapia respiratoria, ejercicios respiratorios.
Abstract. Introduction: Bronchial clearance techniques using oscillatory instrumental devices used in the approach to the COPD patient can improve the cough pattern and favor expiratory flow, thus facilitating the expulsion of secretions, avoiding atelectasis, favoring ventilatory mechanics, oxygenation and maintenance of a patent airway. Methods: A systematic review was carried out following the inclusion criteria based on a search of electronic databases such as: PubMed, Science Direct, Scopus, Springer, Google Scholar, between the period 01/05/2023 to 01/02/2024 in English, Spanish and Portuguese, including studies such as Randomized Clinical Trials and cohort studies. Results: A total of 14 articles were included, 100% in English. The number of participants was 3105, aged between 35 and 85 years, 50.2% of the participants were women. High Frequency Chest Wall Oscillation (HCFWO®) was the most commonly used device 35.7% n=5, followed by Flutter® 28.6% n=4. Intervention time ranged from 1 to 12 weeks, 3 to 7 times per week, 1 to 4 sessions per day, lasting 10 to 30 minutes, between 10 to 20 Hz. Conclusions: The use of HFCWO can have a positive impact on pulmonary rehabilitation, specifically on pulmonary function and oxygenation variables, when implemented as a complementary therapy to early mobilization, therapeutic exercise, and bronchial clearance breathing techniques.
Keywords: COPD, mucociliary clearance, chest wall oscillations, respiratory therapy, breathing exercises.
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