Bronchiectasis

Abstract

This 64 page document presents evidencebased clinical practice guidelines on the background, potential causes, clinical assessments, investigations, and management of adults and children with non-CF bronchiectasis. It begins with a 6-page summary of all recommendations. The guidelines then provide information on the potential underlying causes of bronchiectasis, and its associations with other pathologies. The clinical presentation in both adults and children is detailed, and evidence for diagnostic investigations is provided,such as immunological tests, radiological investigations, sputum microbiology, and lung function tests. General principles of management are indicated, followed by evidence for physiotherapy in this condition. This includes interventions such as airway clearance techniques, active cycle of breathing techniques, manual techniques, positive expiratory pressure, autogenic drainage, high frequency chest wall oscillation, and exercise. The evidence for the use of airway pharmacotherapy such as mucolytics, hyperosmolar agents, bronchodilators, inhaled corticosteroids and leukotriene receptor antagonists are detailed, followed by evidence for management using antibiotics. Recommendations are given for assessments needed in patients with acute exacerbations in the outpatient and inpatient sector, with criteria provided to determine when inpatient treatment of an acute exacerbation is required. Finally, evidence for surgery, complications and management of the advanced disease is provided. All 549 cited references are provided.