CHEST Guidelines-Treating-Cough-Due-to-Non-CF-and-CF-Bronchiectasis

Treating-Cough-Due-to-Non-CF-and-CF-Bronchiectasis

Pdf Summary

The CHEST Expert Panel Report investigates non-pharmacological airway clearance techniques for treating cough in bronchiectasis resulting from cystic fibrosis (CF) and other causes. The review aims to update the 2006 CHEST guidelines by examining evidence on non-pharmacological therapies such as positive expiratory pressure (PEP) devices, high-frequency chest wall oscillation (HFCWO), and others.<br /><br />The study identified systematic reviews but found a scarcity of large randomized controlled trials on the effect of airway clearance techniques on clinically significant outcomes like exacerbation rates, quality of life, hospitalizations, and mortality. Consequently, the panel could not offer formal recommendations but provided consensus-based suggestions:<br /><br />1. Individuals with productive cough from any bronchiectasis should learn airway clearance from trained professionals.<br />2. The frequency of airway clearance should be tailored based on disease severity and secretion volume.<br />3. Techniques should be individualized due to the variety available.<br /><br />The report emphasizes the importance of these practices, despite limited high-quality evidence, as airway clearance remains a standard management component for bronchiectasis.<br /><br />The report calls for future research to focus on trials that clearly address clinically important outcomes and the best airway clearance methods and frequencies. Ethical and practical challenges, like comparing new techniques without standard physiotherapy, have hindered robust studies.<br /><br />Overall, while non-pharmacological airway clearance remains a critical management strategy for bronchiectasis, more high-quality research is needed to solidify its effectiveness across key clinical outcomes.

Keywords

bronchiectasis

cystic fibrosis

airway clearance

non-pharmacological

positive expiratory pressure

high-frequency chest wall oscillation

consensus-based suggestions

quality of life

randomized controlled trials

clinical outcomes