Pediatric airway maintenance and clearance in the acute care setting: How to stay out of trouble

Brian K. Walsh, Kristen Hood, Greg Merritt

Research output: Contribution to journalArticlepeer-review

41 Scopus citations


Traditional airway maintenance and clearance therapy and principles of application are similar for neonates, children, and adults. Yet there are distinct differences in physiology and pathology between children and adults that limit the routine application of adult-derived airway-clearance techniques in children. This paper focuses on airway-clearance techniques and airway maintenance in the pediatric patient with acute respiratory disease, specifically, those used in the hospital environment, prevailing lung characteristics that may arise during exacerbations, and the differences in physiologic processes unique to infants and children. One of the staples of respiratory care has been chest physiotherapy and postural drainage. Many new airway clearance and maintenance techniques have evolved, but few have demonstrated true efficacy in the pediatric patient population. Much of this is probably due to the limited ability to assess outcome and/or choose a proper disease-specific or age-specific modality. Airway-clearance techniques consume a substantial amount of time and equipment. Available disease-specific evidence of airway-clearance techniques and airway maintenance will be discussed whenever possible. Unfortunately, more questions than answers remain.

Original languageEnglish (US)
Pages (from-to)1424-1444
Number of pages21
JournalRespiratory care
Issue number9
StatePublished - Sep 2011
Externally publishedYes


  • Airway clearance
  • Chest physiotherapy
  • Cystic fibrosis
  • Pediatric
  • Respiratory

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine


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