European Respiratory Society statement on airway clearance techniques in adults with bronchiectasis

Beatriz Herrero-Cortina, Annemarie L. Lee, Ana Oliveira, Brenda O'Neill, Cristina Jácome, Simone Dal Corso, William Poncin, Gerard Muñoz, Deniz Inal-Ince, Victoria Alcaraz-Serrano, Gregory Reychler, Angela Bellofiore, Thomy Tonia, James D. Chalmers, Arietta Spinou (Lead / Corresponding author)

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)


Airway clearance techniques (ACTs) are part of the main management strategy for patients with bronchiectasis. Despite being a priority for patients, accessibility, implementation, and reporting of ACTs are variable in clinical settings and research studies. This European Respiratory Society statement summarises current knowledge about the ACTs in adults with bronchiectasis and makes recommendations to improve future evidence base. A task force of 14 experts and two patient representatives (10 countries) determined the scope of this statement through consensus and defined six questions. The questions were answered based on systematic searches of the literature.The statement provides a comprehensive review of the physiological rationale for ACTs in adults with bronchiectasis, and the mechanisms of action along with the advantages and disadvantages of each ACT. Evidence on the ACTs in clinical practice indicates that active cycle of breathing techniques, positive expiratory pressure devices and gravity assisted drainage technique are the most frequently used techniques, although there is limited evidence on the type of ACTs used in specific countries. A review of 30 randomised trials for the effectiveness of the ACTs shows that these interventions increase sputum clearance during or after treatment, reduce the impact of cough and the risk of exacerbations, and improve health-related quality of life. Furthermore, strategies for reducing the risk of bias in future studies are proposed. Finally, an exploration of patientś perceptions, barriers and enablers related to this treatment is also included to facilitate implementation and adherence to ACTs.

Original languageEnglish
Article number2202053
Number of pages37
JournalEuropean Respiratory Journal
Issue number1
Early online date4 May 2023
Publication statusPublished - 2023


Dive into the research topics of 'European Respiratory Society statement on airway clearance techniques in adults with bronchiectasis'. Together they form a unique fingerprint.

Cite this