A critical evaluation of bronchial hygiene in pediatric pulmonary disease.

The variables inherent in analyzing the effectiveness of modalities used to achieve 
bronchial hygiene are numerous. Treatments may be given in a variety 
of settings, including intensive-care units, pediatric wards, respiratiory therapy departments, physical 
therapy departments, chronic-care hospitals, special education centers, and patient homes. Treatments 
are administered by a variety of medical professionals, allied health personnel, 
and lay volunteers. Motivation of the care providers as well as 
of the patients may vary greatly. Also, efforts are needed to 
study patients at comparable stages in their growth and development and 
in the progression of their particular diseases. Rather than perpetuating the 
unquestioning use of these various treatments, a series of carfully constructed 
and controlled studies done in collaborative fashion need to be performed. 
Until that time, the recommendations we have outlined dealing with each 
of the various segments of bronchial hygiene may serve as useful 
guidelines. 