Patient polyhandicapé et épisode d'insuffisance respiratoire aigu : prise en charge en milieu hospitalier

Acute respiratory failure in severe disabled people is a frequent and serious complication with a high morbidity and mortality rate. Common management relies on antibiotic therapy combined with clearance of airway secretions. Several manual and instrumental airway clearance techniques can be used to improve patients and tend to avoid mechanical ventilation, which is a controversial ethical issue. Postural changes should be associated with these techniques to decrease muscular contraction and enhance alveolar recruitment. This article is an overview of the most useful airway clearance techniques in disabled patients.