CHEST Guidelines-Treating Cough Due to Non-CF and CF Bronchiectasis With Nonpharmacological Airway Clearance

Treating Cough Due to Non-CF and CF Bronchiectasis With Nonpharmacological Airway Clearance

Pdf Summary

The CHEST Expert Panel Report evaluates non-pharmacological airway clearance techniques in managing cough due to bronchiectasis from cystic fibrosis (CF) and other causes. This review aimed to update the 2006 CHEST guideline on cough by conducting a systematic review to determine the clinical significance of these therapies in treating bronchiectasis.<br /><br />Key findings highlight the lack of large, high-quality randomized controlled trials on non-pharmacological airway clearance and its effects on exacerbation rates, quality of life, hospitalization, and mortality in both CF and non-CF bronchiectasis. Despite the absence of robust evidence, the panel underscores the importance of airway clearance as a standard management practice and suggests adopting an individualized approach based on disease severity and secretions.<br /><br />The report presents consensus-based suggestions recommending that healthcare professionals with specialized training teach airway clearance techniques to both children and adults. It suggests tailoring the frequency of these techniques based on individual patient needs and disease severity. <br /><br />The document also emphasizes the pressing need for research into the effectiveness of different airway clearance techniques. It calls for future studies to focus on determining the most effective methods, their duration, and frequency for sustained use, aiming to improve clinically meaningful outcomes like quality of life and reduced exacerbation rates.<br /><br />Ultimately, the report acknowledges ongoing gaps in evidence but upholds airway clearance as vital in bronchiectasis management, urging the field toward more targeted and high-quality research.

Keywords

airway clearance

bronchiectasis

cystic fibrosis

CHEST guideline

non-pharmacological

randomized controlled trials

quality of life

individualized approach

healthcare professionals

research gaps