Treating Cough Due to Non-CF and CF Bronchiectasis With Nonpharmacological Airway Clearance: CHEST Expert Panel Report

Chest: The Journal of Circulation, Respiration and Related Systems

Donald C. Bolser^3¹  Paul Davenport^4²  Stuart B. Mazzone^8³  Anne B. Chang^6,7⁴  Alan F. Barker^2⁵  Adam T. Hill^1⁷  Belinda Ireland^5⁸  Lorcan McGarvey^9⁹ 

[1] College of Veterinary Medicine, University of Florida, Gainesville, FL^3;Department of Physiological Sciences, University of Florida, Gainesville, FL^4;Department of Respiratory and Sleep Medicine, Lady Cilento Children's Hospital, Queensland University of Technology, Brisbane, QLD, Australia^7;Menzies School of Health Research, Darwin, NT, Australia^6;Oregon Health & Science University, Portland, OR^2;Queens University Belfast, Belfast, United Kingdom^9;Royal Infirmary and University of Edinburgh, Edinburgh, Scotland^1;The Evidence Doc, Pacific, MO^5;University of Melbourne, VIC, Australia^8

关键词: bronchiectasis;    cough;    cystic fibrosis;    evidence-based medicine;    guidelines;    ACBT;    active cycle breathing technique;    CCPT;    conventional chest physiotherapy techniques;    CF;    cystic fibrosis;    HFCWO;    high-frequency chest wall oscillation;    PEP;    positive expiratory pressure;    PICO;    Population;    Intervention;    Comparator;    Outcome;   

DOI  :  10.1016/j.chest.2018.01.014

学科分类：呼吸医学

来源: American College of Chest Physicians

【 摘 要 】

Background In bronchiectasis due to cystic fibrosis (CF) and other causes, airway clearance is one of the mainstays of management. We conducted a systematic review on airway clearance by using non-pharmacological methods as recommended by international guidelines to develop recommendations or suggestions to update the 2006 CHEST guideline on cough. Methods The systematic search for evidence examined the question, "Is there evidence of clinically important treatment effects for non-pharmacological therapies in cough treatment for patients with bronchiectasis?" Populations selected were all patients with bronchiectasis due to CF or non-CF bronchiectasis. The interventions explored were the non-pharmacological airway clearance therapies. The comparison populations included those receiving standard therapy and/or placebo. Clinically important outcomes that were explored were exacerbation rates, quality of life, hospitalizations, and mortality. Results In both CF and non-CF bronchiectasis, there were systematic reviews and overviews of systematic reviews identified. Despite these findings, there were no large randomized controlled trials that explored the impact of airway clearance on exacerbation rates, quality of life, hospitalizations, or mortality. Conclusions Although the cough panel was not able to make recommendations, they have made consensus-based suggestions and provided direction for future studies to fill the gaps in knowledge.

【 授权许可】

CC BY