Airway Clearance Techniques in Bronchiectasis
| Autor: | Gregory Tino, Kevin P. Fennelly, Michael R. Knowles, Matthias Salathe, Charles L. Daley, Kevin L. Winthrop, Peadar G. Noone, Anne E. O'Donnell, Kenneth N. Olivier, David E. Griffith, Margaret M. Johnson, Timothy R. Aksamit, Doreen Addrizzo-Harris, Angela DiMango, Andreas Schmid, M. Leigh Anne Daniels, Mark L. Metersky, Byron Thomashow, Alan F. Barker, Ashwin Basavaraj, Radmila Choate, Edward Eden |
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| Rok vydání: | 2020 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty education.field_of_study Bronchiectasis Productive Cough Exacerbation business.industry Population Critical Care and Intensive Care Medicine medicine.disease Pulmonary function testing 03 medical and health sciences 0302 clinical medicine 030228 respiratory system Internal medicine medicine Sputum Population study 030212 general & internal medicine medicine.symptom Airway clearance technique Cardiology and Cardiovascular Medicine business education |
| Zdroj: | Chest. 158:1376-1384 |
| ISSN: | 0012-3692 |
| Popis: | 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 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. |
| Databáze: | OpenAIRE |
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