Airway Clearance Techniques in Bronchiectasis: Analysis From the United States Bronchiectasis and Non-TB Mycobacteria Research Registry.

Autor:	Basavaraj A; New York University School of Medicine, New York, NY. Electronic address: Ashwin.basavaraj@nyulangone.org., Choate R; Research, the COPD Foundation, Miami, FL; College of Public Health, University of Kentucky, Lexington, KY., Addrizzo-Harris D; New York University School of Medicine, New York, NY., Aksamit TR; Pulmonary Disease and Critical Care Medicine, Mayo Clinic, Rochester, MN., Barker A; Department of Pulmonology, OHSU School of Medicine, Portland, OR., Daley CL; Division of Mycobacterial and Respiratory Infections, National Jewish Health, Denver, CO., Anne Daniels ML; University of North Carolina at Chapel Hill, Chapel Hill, NC., Eden E; Icahn School of Medicine, Mt Sinai West and Mt Sinai St Luke's Hospitals, Mt Sinai, NY., DiMango A; Center for Chest Disease, Columbia College of Physicians and Surgeons, New York, NY., Fennelly K; National Heart Lung and Blood Institute, NIH, Bethesda, MD., Griffith DE; University of Texas at Tyler, Tyler, TX., Johnson MM; Pulmonary and Critical Care, Mayo Clinic Florida, Jacksonville, FL., Knowles MR; University of North Carolina at Chapel Hill, Chapel Hill, NC., Metersky ML; Division of Pulmonary and Critical Care Medicine, University of Connecticut School of Medicine, Farmington, CT., Noone PG; University of North Carolina at Chapel Hill, Chapel Hill, NC., O'Donnell AE; Georgetown University Medical Center, Washington, DC., Olivier KN; National Heart Lung and Blood Institute, NIH, Bethesda, MD., Salathe MA; University of Miami Miller School of Medicine, Miami, FL., Schmid A; University of Miami Miller School of Medicine, Miami, FL., Thomashow B; Center for Chest Disease, Columbia College of Physicians and Surgeons, New York, NY., Tino G; University of Pennsylvania Perelman School of Medicine, Philadelphia, PA., Winthrop KL; Department of Pulmonology, OHSU School of Medicine, Portland, OR; Department of Infectious Disease, OHSU School of Medicine, Portland, OR.
Jazyk:	angličtina
Zdroj:	Chest [Chest] 2020 Oct; Vol. 158 (4), pp. 1376-1384. Date of Electronic Publication: 2020 Jul 03.
DOI:	10.1016/j.chest.2020.06.050
Abstrakt:	Background: In patients with bronchiectasis, airway clearance techniques (ACTs) are important management strategies. Research Question: What are the differences in patients with bronchiectasis and a productive cough who used ACTs and those who did not? What was the assessment of bronchiectasis exacerbation frequency and change in pulmonary function at 1-year follow up? Study Design and Methods: Adult patients with bronchiectasis and a productive cough in the United States Bronchiectasis and NTM Research Registry were included in the analyses. ACTs included the use of instrumental devices and manual techniques. Stratified analyses of demographic and clinical characteristics were performed by use of ACTs at baseline and follow up. The association between ACT use and clinical outcomes was assessed with the use of unadjusted and adjusted multinomial logistic regression models. Results: Of the overall study population (n = 905), 59% used ACTs at baseline. A greater proportion of patients who used ACTs at baseline and follow up continuously had Pseudomonas aeruginosa (47% vs 36%; P = .021) and experienced an exacerbation (81% vs 59%; P < .0001) or hospitalization for pulmonary illness (32% vs 22%; P = .001) in the prior two years, compared with those patients who did not use ACTs. Fifty-eight percent of patients who used ACTs at baseline did not use ACTs at 1-year follow up. There was no significant change in pulmonary function for those who used ACTs at follow up, compared with baseline. Patients who used ACTs at baseline and follow up had greater odds for experiencing exacerbations at follow up compared with those patients who did not use ACTs. Interpretation: In patients with bronchiectasis and a productive cough, ACTs are used more often if the patients have experienced a prior exacerbation, hospitalization for pulmonary illness, or had P aeruginosa. There is a significant reduction in the use of ACTs at 1-year follow up. The odds of the development of a bronchiectasis exacerbation are higher in those patients who use ACTs continuously, which suggests more frequent use in an ill bronchiectasis population. (Copyright © 2020 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu