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

Adam T. Hill, Alan F. Barker, Donald C. Bolser, Paul Davenport, Belinda Ireland, Anne B. Chang, Stuart B. Mazzone, Lorcan McGarvey, Todd M. Adams, Kenneth W. Altman, Elie Azoulay, Surinder S. Birring, Fiona Blackhall, Louis Philippe Boulet, Christopher Brightling, Priscilla Callahan-Lyon, Terrie Cowley, Ali A. El Solh, Patricio Escalante, Stephen K. FieldDina Fisher, Cynthia T. French, Peter Gibson, Susan M. Harding, Anthony Harnden, Richard S. Irwin, Peter J. Kahrilas, Joanne Kavanagh, Karina A. Keogh, Kefang Lai, Andrew P. Lane, Kaiser Lim, J. Mark Madison, Mark A. Malesker, Joshua P. Metlay, Alex Molasoitis, Abigail Moore, M. Hassan Murad, Mangala Narasimhan, Huong Q. Nguyen, Peter Newcombe, John Oppenheimer, Marcos I. Restrepo, Mark Rosen, Bruce Rubin, Jay H. Ryu, Sonal Singh, Maeve P. Smith, Susan M. Tarlo, Julie Turmel, Anne E. Vertigan, Gang Wang, Miles Weinberger

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)986-993
Number of pages8
Issue number4
StatePublished - Apr 1 2018


  • bronchiectasis
  • cough
  • cystic fibrosis
  • evidence-based medicine
  • guidelines

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine
  • Pulmonary and Respiratory Medicine


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