Airway clearance (non-pharmacology)

Akmal Hafizah Zamli
Sungai Buloh Hospital, Sungai Buloh, Selangor

Bronchiectasis is a chronic respiratory condition characterized by irreversible bronchial dilation, persistent airway inflammation, and impaired mucociliary clearance. Effective management of bronchiectasis requires strategies to enhance airway clearance and reduce exacerbations. Non-pharmacological airway clearance techniques (ACTs) play a central role in this approach. Commonly used methods include physiotherapy-based interventions such as postural drainage, active cycle of breathing techniques (ACBT), autogenic drainage and chest percussions. The use of pulmonary adjuncts such as positive expiratory pressure (PEP) devices, mechanical chest percussor, mechanical insufflation-exsufflation devices, high-frequency chest wall oscillation (HFCWO) are often indicated in providing pulmonary rehabilitation for bronchiectasis. These methods aim to mobilize and expel bronchial secretions, improve ventilation, and enhance quality of life. Evidence suggests that individualized ACT regimens can reduce sputum volume, improve lung function, and decrease the frequency of exacerbations. This workshop highlights the current practice of non-pharmacological ACTs in bronchiectasis, emphasizing their role as an essential component of long-term disease management.