Bronquiectasia e fisioterapia desobstrutiva: ênfase em drenagem postural e postural e a percussão são efetivas na mobilização da secreção pulmonar, uma . NAC. rtousp () Limpeza brônquica na portadores de bronquiectasia, atendidosno Laboratóriode Fisioterapia Respiratória do. Primera página del artículo de sobre bronquiectasias. y no están tan habituados al empleo de la fisioterapia respiratoria como tratamiento. na. De todos ellos, el análisis multivariado determinó que la presencia de obstrucción.
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Bronchopulmonary hygiene physical therapy in bronquiectasis and chronic obstructive disease: Infection with Mycobacterium avium complex in patients without predisposing conditions. This requires the assistance of brlnquiectasia professional, which can make the necessary daily treatment difficult.
The techniques require care in their application and some are performed independently such as Flutter, autogenic drainage and the positive expiratory pressure technique and others not, such as postural drainage, percussion, intrapulmonary percussive ventilation and vibrocompression. Other causes include infections, obstructions, inhalation and aspiration of ammonia, gastric aspiration, alcoholism, heroin use, allergies, rheumatologic and neurological diseases, non-specific low respiratory function after infections, cystic fibrosis and primary immunodeficiency [5,8].
Cohen M, Sahn SA. Long-term comparative trial of positive expiratory pressure versus oscillating positive expiratory pressure flutter physiotherapy in the treatment of cystic fibrosis. Bronchiectasis is classified in cylindrical, varicose and saccate and in focal or multiple segmental. After establishing the existence of the disease and discarding the hypothesis of surgery, conservative treatment is initiated  which includes bronchodilator drugs, mucolytic agents, corticoids and antibiotics, as well as hyper-dehydration and bronchoaspiration .
Effects of postural drainage have been investigated using pulmonary function rbonquiectasia and analysis of the arterial gases. From these results, the authors concluded that respiratory physiotherapy by means of bronchial hygiene was efficacious without imposing an excessive physical load. On the other hand, further studies are necessary the identify physiotherapeutic protocols, their duration, repetitions, frequency, number of professionals involved, description of the selected techniques and the cost-benefit ratio for the patient [12,17].
For this reason, in some countries, physiotherapists have utilized techniques that facilitate application and thus independence of the patient . Results of surgical and conservative management: The immunological component of the bronquoectasia inflammatory infiltrate in bronchiectasis. Physiotherapeutic interventions and clinical manifestations of the disease reflect in the psychological and social aspects of the patient, as despite of guaranteeing an improvement in the bronchial mucous transportation, the disease can have negative effects such as dependence on interventions by a professional and the necessity of fisioteraipa therapy every day.
POSTURAL DRAINAGE Postural drainage consists in using gravitational forces from the positioning of the patient so as to increase the transportation of mucous from lobes and specific sections of the lungs in the direction of the central airways, where the secretions should be removed more rapidly through coughing and aspiration [12,15].
Management of massive hemoptysis by bronchial artery embolization. Eur Respir J ; The Brazilian Journal of Cardiovascular Surgery is indexed in: Nevertheless, the final positive expiratory pressure technique provides a significantly greater improvement in the pulmonary function when compared to postural drainage with percussion.
Postural drainage and chest clapping are commonly used clearence however, there are few published comparative population studies or reviews of techniques. Previous article Back to the Top Next article. Nevertheless, there bronnquiectasia no application protocols that prove their efficiency in the maintenance or the improvement of pulmonary function in patients with cystic fibrosis or bronchiectasis.
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Am J Physiol ; N Engl J Med ; Physiotherapy and bronchial mucus transport. The etiology of bronchiectasis is non-specific, represented as the final stage of several pathologic processes .
Analyzing the results, they observed a greater impact on the health of the patients that utilized Flutter, reflected in the number of hospitalizations and in the pulmonary function. Bronchiectasis is a frequently found disease in medical practice in Brazil leading to significant morbidity and decrease in quality of life of the affected individuals. The contraindications, according to the American Association of Respiratory Careas reported by Fink  include pulmonary tuberculosis, tumoral resection from the thorax or neck, pulmonary contusion and coagulopathies.
The affected airways become flaccid and tortuous with obstructions and fibrosis . However, there are few studies that show the association of these techniques, even though they are commonly used in clinical practice. Gomes Neto et al.
An investigation into causative factors in patients with bronchiectasis.
Ten patients were submitted to alternate sessions of the Flutter VRP1 device and postural drainage, percussion and vibration with two sessions weekly for four bronqjiectasia. The follow up showed that most of the surgically treated patients had significant nw improvement and rarely needed to be re-hospitalized. The surgical treatment of nna and localized bronchiectasis. This technique has been scientifically proven to be relevant in the bronchial hygiene of patients suffering from cystic fibrosis and bronchiectasis .
In the works by Caromano et al. The majority of the published studies do not show significant differences in the results when comparing the efficacy of the clearance techniques, suggesting that the most comfortable technique and the one that has less social compromise should be utilized for the patient.
The pulmonary lesions were unilateral in Bronqhiectasia to percussion and postural drainage: Am J Pathol ; Van der Schans et al. Immediate and long-term results of bronchial artery embolization for life-threatening hemoptysis. Pryor  stressed the efficiency of the maneuvers of forced expiration and Caromano et al.
Bronchiectasis: diagnostic and therapeutic features A study of patients
New physiotherapeutic techniques appeared including the Flutter device, autogenic drainage, forced expiration technique, active cycle, expiratory positive pressure therapy and intrapulmonary percussive ventilation [3,11,12,14]. The physiotherapeutic sessions lasted brobquiectasia hour, with inhalation of saline solution associated with postural drainage in the lateral decubitus position, vibrocompression and active-assisted mobilization of the thorax.
However, due to the emergence of preventative programs in developed countries, the number of hospitalizations for bronchiectasis has dropped over the last few decades, with high prevalence and incidence only in under-developed countries [4,5]. Hum Pathol ; However, today they are associated with other techniques [11,14].
Current strategy for surgical management of bronchiectasis. Reviews of publications and field studies emerged due to the apparent necessity of research on the cost-benefits of physiotherapeutic procedures of bronchial hygiene for bronchiectasis . The physiopathology consists of colonization of microorganisms and in the interaction of several enzymes and chemical mediators that cause inflammatory reactions and destruction of the bronchial tree; there is infiltration of neutrophils in the tissue that reduce the frequency of ciliary beats, resulting in impairment of the mucociliary transport and consequent bronchial obstruction [1,4].
This procedure promotes the mobilization of the secretions by means of vibrations  and is performed with the patient in varying drainage positions .
Predicting outcome following pulmonary resection in cystic fibrosis patients.