Non-cystic fibrosis (CF) bronchiectasis symptoms are frequently managed with the use of airway clearance techniques (ACTs), and a new review of literature aimed to evaluate and compare the efficiency of such interventions for bronchiectasis patients in a stable state or during acute exacerbations. According to Lung Disease News, the primary objective of the review was to determine the effect of ACTs on health-related quality of life (HRQoL), incidences of hospitalization, and rates of acute exacerbation in patients with stable and acute bronchiectasis.
The secondary objectives of the review aimed to determine if ACTs are safe and beneficial to patients’ physiology and symptoms. The researchers searched relevant journals, PEDro, and the Cochrane Airways Group Specialized Register of trials. Ultimately, they came up with seven studies involving 105 participants that met their inclusion criteria. Two of the studies suggested a small improvement in quality of life and in disease-specific and cough-related measures, specifically with high-frequency chest wall oscillation (HFCWO) or a group ACTs.
Additionally, these techniques also show some effect on improving clearance of mucus and some parameters used to evaluate lung function, such as forced vital capacity (FVC). The Lung Disease News notes that ACTs seem to be safe for adults and children with stable bronchiectasis, according to the data evaluated, while hospitalization and prescription of antibiotics were not reported. Weak evidence also suggests improvements in symptoms of breathlessness and cough, but no change in oxygenation.
The researchers note that only two of these studies were conducted for 6 months. As such, prediction of long-term effects is not possible. The Lung Disease News report indicates that the methods used in the trials were not well-reported and the researchers considered the evidence to be preliminary and low quality.
The authors of the study concluded, “The role of these techniques in acute exacerbation of bronchiectasis is unknown. In view of the chronic nature of bronchiectasis, additional data are needed to establish the short-term and long-term clinical value of ACTs for patient-important outcomes and for long-term clinical parameters that impact disease progression in individuals with stable bronchiectasis, allowing further guidance on prescription of specific ACTs for people with bronchiectasis.”
Source: Lung Disease News