Respiratory failure & ventilation
Physiological and clinical effects of selected airway clearance techniques in mechanically ventilated adult ICU patients: a systematic review and synthesis without meta-analysis
Authors' conclusion
Selected ACTs may improve short-term secretion clearance in invasively ventilated ICU patients. However, the evidence is largely limited to surrogate physiological outcomes and is of low certainty for clinically meaningful outcomes, whose effects remain uncertain.
Study context
- Population
- Invasively mechanically ventilated adult ICU patients
- Participants
- 1,884 participants · 46 studies
- Comparison
- Airway clearance techniques (ACTs) vs Standard care or suctioning alone
- Outcome
- Secretion clearance (e.g., sputum weight or volume)
Methodological detailssynthesis without meta-analysis, PRISMA
- Synthesis without meta-analysis
- PRISMA
Pooled result
As reported in the abstract
Secretion clearance
- Greater secretion clearance with ACTs vs standard care or suctioning alone in several studies; findings varied across techniques, comparisons and outcome definitions
- Expiratory rib-cage compression (ERCC), mechanical insufflation-exsufflation (MI-E) and hyperinflation associated with increased secretion clearance in some studies; PEEP-ZEEP results inconsistent
Further pooled results
Respiratory mechanics, oxygenation and clinical outcomes
- Variable and predominantly short-term effects
Mortality, duration of mechanical ventilation, ICU LOS
- No clear effect
Safety
- No major adverse events reported
Original publication
Physiological and clinical effects of selected airway clearance techniques in mechanically ventilated adult ICU patients: a systematic review and synthesis without meta-analysis. Crit Care. Published 3 July 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →