Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Apr;153(4):986-993.
doi: 10.1016/j.chest.2018.01.014. Epub 2018 Jan 31.

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

Adam T Hill  1 , Alan F Barker  2 , Donald C Bolser  3 , Paul Davenport  4 , Belinda Ireland  5 , Anne B Chang  6 , Stuart B Mazzone  7 , Lorcan McGarvey  8
Affiliations

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

Adam T Hill et al. Chest. 2018 Apr.

Abstract

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.

Keywords: bronchiectasis; cough; cystic fibrosis; evidence-based medicine; guidelines.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Preferred Reporting Items for Systematic Reviews and Meta-analyses flow chart for non-pharmacological airway clearance treatment for children and adults with CF and non-CF bronchiectasis. ∗An updated Cochrane systematic review (SR) for CF and an updated SR in the overview of SR for non-CF bronchiectasis were discovered during the May 2016 search and replaced the older versions. CF = cystic fibrosis.
See this image and copyright information in PMC

References

    1. Pasteur M.C., Bilton D., Hill A.T. British Thoracic Society guideline for non-CF bronchiectasis. Thorax. 2010;(65 suppl 1):i1–i58. - PubMed
    1. Hill AT, on behalf of the British Thoracic Society. British Thoracic Society Quality Standards for clinically significant bronchiectasis in adults. https://www.brit-thoracic.org.uk/document-library/clinical-information/b.... Accessed February 20, 2018. - PMC - PubMed
    1. Chang A.B., Bell S.C., Torzillo P.J. Chronic suppurative lung disease and bronchiectasis in children and adults in Australia and New Zealand Thoracic Society of Australia and New Zealand guidelines. Med J Aust. 2015;202(1):21–23. - PubMed
    1. Rosen M.J. Chronic cough due to bronchiectasis: ACCP evidence-based clinical practice guidelines. Chest. 2006;129(suppl 1):122S–131S. - PubMed
    1. Smyth A.R., Bell S.C., Bojcin S. European Cystic Fibrosis Society Standards of Care: best practice guidelines. J Cyst Fibros. 2014;13(suppl 1):S23–S42. - PubMed

Publication types