Airway Clearance in Bronchiectasis

The chapter describes the bronchiectasis pathophysiology that informs and influences airways clearance techniques (ACT) and provides an overview of the aims of ACT and current practices in bronchiectasis. The main physiological mechanisms underlying ACTs as well as the current evidence base are detailed. Mucoactive drugs are discussed particularly in terms of dose, delivery device/route and timing with ACT to facilitate airway clearance. Recognising that the evidence base for ACT in bronchiectasis is low with few high-quality studies, a review of the outcomes used in randomised crossover and controlled trials (RCTs) in bronchiectasis has been included. This has also focused on the utility and feasibility of the commonly used endpoints as well as the potential clinical endpoints that could be considered for use in future ACT clinical trials.