• Adam T Hill, Alan F Barker, Donald C Bolser, Paul Davenport, Belinda Ireland, Anne B Chang, Stuart B Mazzone, and Lorcan McGarvey.
• Royal Infirmary and University of Edinburgh, Edinburgh, Scotland. Electronic address: adam.hill318@nhs.net.
• Chest. 2018 Apr 1; 153 (4): 986993986-993.

BackgroundIn 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.MethodsThe 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.ResultsIn 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.ConclusionsAlthough 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.Copyright © 2018 American College of Chest Physicians. All rights reserved.

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