ArticleMedical principles and practice : international journal of the Kuwait University, Health Science Centre2026
Physiology-Guided Selection of Hardware-Assisted Airway Clearance Techniques during Acute Exacerbations of Non-Cystic Fibrosis Bronchiectasis.
Article in Medical principles and practice : international journal of the Kuwait University, Health Science Centre, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
<p>Introduction: The aim of this study was to assess the short-term clinical effects of individualized, hardware-assisted airway clearance techniques (ACTs) during acute non-cystic fibrosis bronchiectasis (NCFB exacerbations).
methodsIn this prospective, controlled cohort study, 46 adults hospitalized with computed tomography-confirmed bilateral (CT-confirmed bilateral) NCFB were assigned to an intervention group (ACT plus pharmacological therapy; n = 23) or a control group (pharmacological therapy alone; n = 23). ACT modality (intrapulmonary percussive ventilation [IPV], high-frequency chest wall oscillation, or mechanical insufflation-exsufflation) was selected based on IPV tolerability and respiratory muscle strength maximum inspiratory pressure Z-score. Outcomes included 24-hour sputum volume, dyspnea (modified medical research council dyspnea scale [mMRC], Borg), spirometry, inflammatory markers, and length of hospital stay.
resultsCompared with controls, the intervention group showed greater reductions in sputum volume (-15 vs. -10 mL; p = 0.005) and dyspnea (mMRC -1.0 vs. 0.0; Borg -2.0 vs. -1.0; all p < 0.05), as well as a shorter hospital stay (median 7 vs. 9 days; p < 0.05). There were no differences between groups in spirometric or inflammatory outcomes, and no serious adverse events occurred.
conclusionsIndividualized, physiology-guided device-based ACTs improved mucus clearance and dyspnea during acute NCFB exacerbations and were well tolerated, without short-term spirometric change. Larger studies with longer follow-up are needed to confirm efficacy before routine clinical implementation. </p>.
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