Airway Clearance Research Articles

EPS8.02 Evolving physiotherapy airway clearance technique (ACT) interventions during cystic fibrosis (CF) pregnancy in the variant specific therapy (VST) era

EPS8.02 Evolving physiotherapy airway clearance technique (ACT) interventions during cystic fibrosis (CF) pregnancy in the variant specific therapy (VST) era

P457 Kids ACTing Up: Airway clearance therapy adherence and mucolytic use after starting elexacaftor/tezacaftor/ivacaftor

P457 Kids ACTing Up: Airway clearance therapy adherence and mucolytic use after starting elexacaftor/tezacaftor/ivacaftor

EPS4.06 Safety of exercise as an airway clearance technique to replace chest physiotherapy in people with cystic fibrosis: preliminary insights from the ExACT-CF trial

EPS4.06 Safety of exercise as an airway clearance technique to replace chest physiotherapy in people with cystic fibrosis: preliminary insights from the ExACT-CF trial

Nursing Care for Oxygenation Needs Disorder in Patients Diagnosed with Bronchitis in the Jimbaran Lama Ward

Ineffective airway clearance is one of the oxygenation disorders in patients with respiratory disorders (bronchitis). One of the practical nursing actions is to cough effectively to remove mucus in the respiratory tract. This study aimed to determine and analyze nursing care for impaired oxygenation needs in patients with a medical diagnosis of bronchitis in the old Jimbaran room. This research method uses a descriptive design as a nursing practice case study approach. The case study examines the respiratory rate (RR) of patients with respiratory disorders (bronchitis) after giving effective coughing measures for 3x24 hours. The results showed that the patient's RR before implementation was 24 x/min. In comparison, after being given an effective cough implementation for 3x24 hours, the RR was 20 x/min. In conclusion, nursing actions that need to be taken in patients with respiratory disorders (bronchitis) include assessing sputum production, effective coughing techniques, counseling regarding positioning, and collaborative oxygen or nebulizer administration. The implication of this study is the importance of effective coughing measures in managing bronchitis patients, including evaluation of sputum production, training in proper coughing techniques, education on proper positioning, and collaboration with oxygen or nebulizer administration as needed. Synchronization between research objectives and research conclusions. Present the research subject, research criteria, data collection methods, and data analysis.

Effect of physical rehabilitation using oromotor stimulation, manual airway clearance technique, positioning, tactile and kinaesthetic stimulation (PROMPT) protocol on respiratory and neuromuscular function in neonatal respiratory distress syndrome (NRDS)- a protocol for randomized controlled trial

Background Neonatal Respiratory Distress Syndrome (NRDS) remains a significant challenge in neonatal care, often leading to respiratory compromise and neuromuscular dysfunction. While advances in medical management have improved outcomes, adjunctive therapies such as physical rehabilitation offer potential benefits yet require further investigation. This protocol outlines a randomized controlled trial aiming to evaluate the effect of Physical Rehabilitation using Oro Motor Stimulation, Manual Airway Clearance Technique, Positioning, Tactile, and Kinesthetic Stimulation (PROMPT) protocol on respiratory and neuromuscular function in neonates with NRDS. Methods The trial will include 38 neonates diagnosed with NRDS, randomly allocated into two groups: the intervention group receiving the PROMPT protocol alongside standard care, and the control group receiving standard care alone. The PROMPT protocol comprises a comprehensive approach targeting oromotor stimulation, manual airway clearance technique, optimal positioning, and tactile/kinesthetic stimulation. Outcome measures Primary outcomes will focus on respiratory parameters such as oxygenation index, ventilatory support requirements, and neuromuscular function assessed through muscle tone and reflexes. Secondary outcomes will encompass length of hospital stay, incidence of complications, and neurodevelopmental outcomes at follow-up. Results Data analysis will employ appropriate statistical methods to compare outcomes between the intervention and control groups, with adjustments for potential confounders. Ethical approval has been obtained, and informed consent will be obtained from parents or legal guardians before enrolment. Conclusion This trial protocol aims to provide valuable insights into the efficacy and safety of the PROMPT protocol as a rehabilitative intervention for NRDS. The findings may inform future clinical practice and contribute to optimizing care strategies for neonates with NRDS, ultimately improving their short- and long-term outcomes. Registration CTRI/2024/03/064911

Bronchiectasis management in adults: state of the art and future directions.

Formerly regarded as a rare disease, bronchiectasis is increasingly recognised. A renewed interest in this disease has led to significant progress in bronchiectasis research. Randomised clinical trials have demonstrated the benefits of airway clearance techniques, inhaled antibiotics and long-term macrolide therapy in bronchiectasis patients. However, the heterogeneity of bronchiectasis remains one of the most challenging aspects of management. Phenotypes and endotypes of bronchiectasis have been identified to help find "treatable traits" and partially overcome disease complexity. The goals of therapy for bronchiectasis are to reduce the symptom burden, improve quality of life, reduce exacerbations and prevent disease progression. We review the pharmacological and non-pharmacological treatments that can improve mucociliary clearance, reduce airway inflammation and tackle airway infection, the key pathophysiological features of bronchiectasis. There are also promising treatments in development for the management of bronchiectasis, including novel anti-inflammatory therapies. This review provides a critical update on the management of bronchiectasis focusing on treatable traits and recent randomised clinical trials.

Management of respiratory issues in patients with Rett syndrome: Italian experts' consensus using a Delphi approach.

Despite the publication of the 2020 guidelines on how to manage Rett Syndrome (RS), some fundamental topics are still open, in particular respiratory problems. Identification and reinforcement of current recommendations concerning the management of respiratory issues in RS patients. Using a Delphi approach, the leading group reviewed the literature and formulated 14 statements. A multidisciplinary panel of 29 experts were invited to score, for each statement, their agreement on a 1-5 scale. The cut-off level for consensus was 75%, obtained through multiple rounds. The panel agreed that in all RS types, respiratory issues should be faced at an early stage, regardless of epilepsy onset. It is recommended to perform periodically sleep studies in all Congenital Rett Syndrome,and in selected cases with other RS types. Noninvasive ventilationshould be considered in all RS subjects with sleep respiratory disorders and in those with hypotonia associated with hypercapnia. Chest physiotherapy should be performed in all RS patients with difficult management of the accumulation of respiratory secretions, using airway clearance techniques and devices (PEP-mask, AMBU bag, or cough machine), more appropriateand tolerated by the patients. The panel recommended individualized programs for the management of scoliosis, and to consider performing gastrostomyin patients at increased risk of ab ingestis pneumonia. This consensus could support everyday clinical practice on respiratory issues in RS patients, complementary to existing recommendations by regulatory agencies and guidelines.

Nurse-led oscillating positive expiratory pressure (OPEP)

Emma Rickards looks at new forms of airway clearance techniques, and how patients take to them

Respiration and Cough in Pompe Disease: Results from a neuromechanical computational model of the respiratory control system

Late Onset Pompe Disease (LOPD) is an incurable, rare progressive genetic disease. It is characterized by glycogen build-up, due to mutations in the gene encoding the lysosomal enzyme acid alpha glucosidase, throughout muscle and neural regions. This accumulation is associated with cell death and muscle fiber swelling, eventually leading to respiratory insuffciency and airway clearance (i.e. cough) deficiency. Impairments in effective airway clearance result from the inability to clear normal pulmonary volume. Emerging evidence indicates significant respiratory neuron dysfunction, altering pulmonary function in humans and animal models. It has been suggested that respiratory and airway clearance insuffciency observed in LOPD may be attributed to medullary motoneurons potentially associated with the respiratory and cough pattern generators (Fuller et al., 2013; DeRuisseau et al., 2009). However, the precise neural mechanisms that suppress breathing and cough are not fully understood. One possible target for LOPD respiratory insuffciencies may be reduced medullary inspiratory neuron activity within this network, which could result in decreased phrenic motoneuron output. Using a stochastic neural network simulator that consisted of discrete “integrate and fire” populations, we simulated a systematic decrease in three medullary inspiratory neuron populations: inspiratory driver (I-Driver), inspiratory decrementing (I-Dec), or inspiratory augmenting (I-Aug) neurons. We simulated breathing and three cough trials. By targeting these populations, we expected global decreased neural bursts, suppressed inspiratory motor drive, and/or suppressed expiratory motoneuron output. Simulations indicated that when the I-Dec motoneuron population decreased by 25%, it resulted in apnea and abolished cough. Reducing the I-Aug motoneuron population by 20% resulted in longer inspiratory phase durations (TI) and a decreased respiratory rate. During cough, there was a decrease in the duration and amplitudes of the expiratory motoneuronal activity associated with decreased cough receptor and pulmonary stretch receptor afferent feedback. When the I-Driver motoneuron population was reduced by 25%, TI decreased and I amplitude increased during respiration. During cough, lumbar and phrenic motoneuron discharge duration and amplitude decreased. These results are consistent with previously reported in vivo data. Overall, our simulation data support the plausibility of glycogen storage dysfunction impairing medullary neuronal and premotoneuronal excitability within the inspiratory network. Our results also suggest that some neurons may be more sensitive to glycogen storage than others within the brainstem inspiratory network. Supported by NHLBI L30HL165496, NIH T32 HL 134621 and 3OT2OD023854. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

The role of electrogenic and electroneutral monocarboxylate transport in airway clearance

Introduction: Monocarboxylates can be transported by the electrogenic Na+-coupled system (SMCTs/SLC5 family) and the electroneutral H+-coupled system (MCTs/SLC16 family). Previously, MCTs have been described in human bronchial epithelium but there is no evidence of SMCTs activity in airways. We describe here for first time that SMCT1/SCL5A8 is functionally expressed in mouse tracheal epithelium. We hypothesized that monocarboxylate transport activity might downregulate airway clearance in mouse tracheas as increased Na+-absorption reduce airway surface liquid (ASL), and increased H+-secretion acidify ASL. Methods: Short-circuit current ( ISC) recordings were performed in bicarbonate buffer with and without Na+, videomicroscopy of particle track speed (PTS) and mucus transport speed were performed in mouse tracheas. Animals (C57BL6/J) were housed at CECs-Animal facility under controlled temperature, humidity and free access to water and food. All protocols were approved (IACUC, #CECs-2022-04), in accordance with relevant regulations. Results: 10 mM apical L-lactate, D-lactate, pyruvate, propionate or acetate induced a negative current ( ISC~ -35 μA·cm−2; n=4-5 each group) and reduced (p<0.05 rank-sum test) when Na+ was replaced. L-lactate or pyruvate, transported by SMCTs and MCTs increased PTS (2.1±0.1 control vs 3.28±0.4 μm·s−1* for L-lactate and 3.31±0.1 μm·s−1* for pyruvate; n=3 each group; * indicates p<0.05 rank-sum test) and inhibited by 30 μM of the MCT inhibitor AR-C155858 (1.9±0.1 μm·s−1). D-lactate, transported by SMCTs only, did not affected PTS (2.03±0.1 μm·s−1; p>0.05; n=3 each group). We observed a reduction of amiloride-sensitive Na+-absorptive currents in tissues incubated with L-lactate compared to non-incubated ( ISC -17±4 μA·cm−2 vs -5±4 μA·cm−2; p<0.05 rank-sum test; n=4 each group). Finally, analysis of mucus transport determined that L- but not D-lactate increased the speed of mucus, that was prevented when tissues were incubated with AR-C155858 (control 1.06 ± 0.05 μm·s−1 vs L-lactate 1.24 ± 0.08 μm·s−1*, vs L-lactate + AR-C155858 1.02 ± 0.06 μm·s−1; * indicates p<0.05 ANOVA on ranks; n=4 each group). Real time PCR determined that the only SMCT expressed in airway epithelium is SLC5A8. Conclusion: SLC5A8 Na+-dependent D-lactate transport didn't affect mucus clearance. This is explained by the fact that ENaC Na+ absorption competes with SMCTs for basolateral Na+ transport, suggesting that both ENaC and SLC5A8 localize in the same cells. On the other hand, monocarboxylates that increase PTS and mucus speed transport might be explained by MCT-dependent H+ removal (alkalization) from ASL. Since alkalization of the airway surface can restore airway clearance, the use of MCTs transportable substrates might help alleviate mucostasis in muco-obstructive diseases. Funded by FONDECYT 1221257 (C.A.F.). This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

The use of LifeVac, a novel airway clearance device, in the assistance of choking victims aged five and under: Results of a retrospective 10-year observational study

Background: Choking is a leading cause of injury and death among children under the age of five. Despite notable advances in technology, regulations, and education, the prevalence of choking incidents and related fatalities persists as a global issue, demanding the implementation of improved assistance methods. This study aims to assess the efficacy of an innovative airway clearance device, LifeVac, in aiding children aged 5 and under in choking emergencies. Subjects and Methods: LifeVac LLC maintained a comprehensive database of voluntary reports documenting the utilization of their device in choking emergencies over 10 years, collected through a dedicated website. Collected data included the age and sex of the choking victim, preexisting medical conditions, nature of the object causing airway obstruction, whether basic life support protocol was followed before employing the LifeVac, number of pulls required to dislodge the obstructing object, and adverse events. Results: A total of 299 children were reported to have received assistance with the LifeVac device in choking emergencies. The age range of the assisted children varied from 3 days old to 5 years. One hundred and fifty-seven children were boys. There were 19 reports of preexisting conditions. The most common obstructing objects were plastic, mucus, candy, meat, and fruits. The number of pulls required to successfully dislodge the object ranged from 1 to 10. No failures were reported. Conclusions: LifeVac should be considered a valuable complement to standard life support techniques in choking emergencies, particularly for at-risk groups such as children under the age of 5.

NURSING CARE ANALYSIS OF ARTIFICIAL RESPIRATORY MANAGEMENT IN STROKE-ASSOCIATED PNEUMONIA (SAP) PATIENTS: A CASE STUDY FROM ICU RSPAL DR. RAMELAN SURABAYA

Introduction: Stroke-associated pneumonia (SAP) is a common complication of stroke, leading to ineffective airway clearance and potentially severe outcomes such as respiratory failure and death. Objective: This case study analyzes the nursing care provided to a SAP patient in the ICU of RSPAL Dr. Ramelan Surabaya, focusing on the application of artificial respiratory management to improve airway clearance Methods: Over five days, the nursing team implemented interventions, including Endotracheal Tube (ETT) care, which partially resolved the ineffective airway clearance. Results: This improvement was evident in the enhanced respiratory parameters and reduced secretion accumulation. Conclusions: The findings highlight the importance of diligent airway management in preventing respiratory complications in SAP patients.

Nonpharmacological Treatment for Nontuberculous Mycobacterial Pulmonary Disease.

Nontuberculous mycobacterial pulmonary disease (NTM-PD) results from the exposure of susceptible hosts to a diverse group of environmental mycobacteria. The emphasis on nonpharmacological strategies is motivated by the widespread presence of NTM in various environments, and the inconsistent success rates of pharmacological treatments. Modifiable factors contributing to NTM-PD development include impaired airway clearance, low body mass index, gastroesophageal reflux disease, and exposure to NTM habitats. This suggests that lifestyle and environmental modifications could affect disease development and progression. The review highlights several modalities that can modify the risk factors. Airway clearance techniques, informed by the "gel-on-brush" model of the bronchial epithelium, aim to enhance mucociliary clearance, and have the potential to alleviate symptoms and improve lung function. The impact of nutritional status is also examined, with a lower body mass index linked to an increased risk and progression of NTM-PD, indicating the importance of targeted nutritional support. Additionally, the theoretical and epidemiological links between gastroesophageal reflux disease and NTM-PD advocate careful management of reflux episodes. Understanding the risk of NTM transmission through environmental exposure to contaminated water and soil is also crucial. Strategies to mitigate this risk, including effective water management and minimizing soil contact, are presented as vital preventive measures. The review supports the inclusion of nonpharmacological treatments within a comprehensive NTM-PD management strategy, alongside conventional pharmacological therapies. This integrated approach seeks to improve the overall understanding and handling of NTM-PD.

Nebulized hypertonic saline and positive expiratory pressure device use in patients with bronchiectasis: Analysis from the United States Bronchiectasis and NTM research registry

BackgroundNebulized Hypertonic saline (HS) and positive expiratory pressure device (PEP) are often used in patients with bronchiectasis. We sought to describe the clinical characteristics in patients using HS and PEP, utilizing a large national database registry. MethodsData from the US Bronchiectasis and NTM Research Registry were used in this study. Patients with a diagnosis of bronchiectasis were included. Eligible patients were assigned to one of four mutually exclusive groups: HS only, PEP only, HS & PEP, or no airway clearance or mucoactive agent. Descriptive statistics were computed for the overall study population and stratified by the four groups. One-way ANOVA and chi-square tests were used to test the difference in the means in continuous variables and the association between categorical variables (respectively) across the four groups. ResultsA total of 2195 patients were included. Of those with bronchiectasis and a productive cough, a greater number of patients utilized HS only vs PEP only (17.5 % vs 9.1 %, p < 0.001). Similar association was found in those with Pseudomonas aeruginosa (22.3 % HS only vs 6.5 % PEP only, p < 0.001). There was a higher number of patients who used HS and PEP therapy in combination vs PEP therapy alone (25.0 % vs 9.1 %, p = 0.002), in those with a productive cough. ConclusionsIn patients with bronchiectasis and a productive cough or Pseudomonas aeruginosa, HS is used more often than PEP alone. There is a need for further analysis to compare these two modalities and explore the factors influencing their utilization.

The changing epidemiology of pulmonary infection in children and adolescents with cystic fibrosis: an 18-year experience.

The impact of evolving treatment regimens, airway clearance strategies, and antibiotic combinations on the incidence and prevalence of respiratory infection in cystic fibrosis (CF) in children and adolescents remains unclear. The incidence, prevalence, and prescription trends from 2002 to 2019 with 18,339 airway samples were analysed. Staphylococcus aureus [-3.86% (95% CI -5.28-2.43)] showed the largest annual decline in incidence, followed by Haemophilus influenzae [-3.46% (95% CI -4.95-1.96)] and Pseudomonas aeruginosa [-2.80%95% CI (-4.26-1.34)]. Non-tuberculous mycobacteria and Burkholderia cepacia showed a non-significant increase in incidence. A similar pattern of change in prevalence was observed. No change in trend was observed in infants < 2years of age. The mean age of the first isolation of S. aureus (p < 0.001), P. aeruginosa (p < 0.001), H. influenza (p < 0.001), Serratia marcescens (p = 0.006) and Aspergillus fumigatus (p = 0.02) have increased. Nebulised amikacin (+ 3.09 ± 2.24 prescription/year, p = 0.003) and colistin (+ 1.95 ± 0.3 prescriptions/year, p = 0.032) were increasingly prescribed, while tobramycin (-8.46 ± 4.7 prescriptions/year, p < 0.001) showed a decrease in prescription. Dornase alfa and hypertonic saline nebulisation prescription increased by 16.74 ± 4.1 prescriptions/year and 24 ± 4.6 prescriptions/year (p < 0.001). There is a shift in CF among respiratory pathogens and prescriptions which reflects the evolution of cystic fibrosis treatment strategies over time.

Airway clearance management in people with bronchiectasis: data from the European Bronchiectasis Registry (EMBARC).

International guidelines recommend airway clearance management as one of the important pillars of bronchiectasis treatment. However, the extent to which airway clearance is used for people with bronchiectasis in Europe is unclear. The aim of the study was to identify the use of airway clearance management in patients with bronchiectasis across different countries and factors influencing airway clearance use. This was a prospective observational study using data from the European Multicentre Bronchiectasis Audit and Research Collaboration (EMBARC) Registry between January 2015 and April 2022. Prespecified options for airway clearance management were recorded, including airway clearance techniques, devices and use of mucoactive drugs. 16 723 people with bronchiectasis from 28 countries were included in the study. The mean age was 67 years (interquartile range 57-74 years, range 18-100 years) and 61% were female. 72% of the participants reported daily sputum expectoration and 52% (95% CI 51-53%) of all participants reported using regular airway clearance management. Active cycle of breathing technique was used by 28% of the participants and airway clearance devices by 16% of participants. The frequency of airway clearance management and techniques used varied significantly between different countries. Participants who used airway clearance management had greater disease severity and worse symptoms, including a higher daily sputum volume, compared to those who did not use it regularly. Mucoactive drugs were also more likely to be used in participants with more severe disease. Access to specialist respiratory physiotherapy was low throughout Europe, but particularly low in Eastern Europe. Only a half of people with bronchiectasis in Europe use airway clearance management. Use of and access to devices, mucoactive drugs and specialist chest physiotherapy appears to be limited in many European countries.

Adherence to chest physiotherapy, airway clearance techniques and physical exercise by children and adolescents with cystic fibrosis

Introduction: chest physiotherapy, airway clearance techniques, and physical exercise are associated with better outcomes in cystic fibrosis, but adherence to these recommendations remains a challenge. Objective: to assess adherence to chest physiotherapy, airway clearance techniques, and physical exercise by children and adolescents with cystic fibrosis and analyze the factors related to adherence. Methods: retrospective study of children and adolescents with cystic fibrosis from a pediatric referral center in Brazil. Data were collected from electronic records of the multidisciplinary team responsible for caring for these patients at the referral center. Results: the sample included all 83 patients registered at the referral center, with a mean age of 7.88 ± 4.88 years. Among them, 28.9% did not have weekly chest physiotherapy, 66.3% did not practice physical exercise regularly, and only 38.6% practiced airway clearance techniques from 6 to 7 times a week. Higher adherence to airway clearance techniques was associated with higher mean age (p&lt;0.01) and correlated with FEV1 (r=-0.39; p=0.03), FEF25-75% (r =-0.36; p=0.02), FEV1/FVC (r =-0.43; p=0.01) and lower mean Shwachman-Kulczycki Score (r=-0.34; p&lt;0.01). Higher physical exercise adherence was associated with a higher mean age (p&lt;0.01). Individuals using public financing of physiotherapy services had a lower Shwachman-Kulczycki Score (p=0.02) than those using non-public services. The metropolitan region had a higher percentage of individuals using non-public services than other regions (p&lt;0.01). Conclusion: adherence to chest physiotherapy, airway clearance techniques and physical exercise was lower than recommendations. Airway clearance techniques and physical exercise adherence increased with age, and airway clearance techniques adherence was associated with the high severity of disease. These results suggest that patients only increase adherence when they get older and the disease worsens, highlighting the need for strategies to increase adherence early.

Systematic review shows that suction-based airway clearance devices for foreign body airway obstruction are promising.

Systematic review shows that suction-based airway clearance devices for foreign body airway obstruction are promising.

EFEKTIVITAS KOMBINASI FISIOTERAPI DADA DAN SUCTION TERHADAP PENURUNAN PRODUKSI SPUTUM PADA PASIEN GAGAL NAFAS DI RUANG ICU RUMAH SAKIT SWASTA 2024: CASE REPORT

Respiratory failure is a failure in the gas exchange function between oxygen and carbon dioxide which can cause decreased consciousness. One of the complications of decreased consciousness that is often encountered is sputum retention. The intervention carried out was chest physiotherapy combined with suction. Based on a preliminary study, it was found that 24 (80%) experienced respiratory failure. To reduce sputum production in patients with respiratory failure with chest physiotherapy intervention combined with suction in the ICU of a private hospital. The research method used in this research is a case report by conducting intervention observations and also airway clearance research with 1 respondent. After chest physiotherapy combined with suction, the results showed an increase in oxygen saturation from 88% to 99% and sputum production decreased from ± 10 cc to ± 7 cc. After chest physiotherapy combined with suction for 3 days, significant results were obtained, namely an increase in oxygen saturation and also a decrease in sputum production. ICU nurses are expected to be able to apply chest physiotherapy combined with suction to reduce sputum production in patients with respiratory failure in the ICU by paying attention to vital signs. Intervention is carried out once a day.

Evaluating Arterial Blood Gas Modifications Before and After Corticosteroid Intervention in Acute Exacerbations of Chronic Obstructive Pulmonary Disease

Background: Chronic Obstructive Pulmonary Disease (COPD), a prevalent and progressive respiratory disorder characterized by airflow limitation and chronic inflammation from prolonged exposure to harmful particles and gases, significantly affects patients' quality of life. Objective: This study examines the impact of corticosteroid therapy on arterial blood gas (ABG) parameters in patients with acute exacerbations of COPD (AECOPD), evaluating ABG values before and after treatment to determine therapeutic effectiveness. Methods: Conducted at Bahawal Victoria Hospital's Pulmonology Department from August 15, 2022, to January 15, 2023, this quasi-experimental study included 202 COPD patients meeting exacerbation criteria. Exclusions included severe systemic illness, unconsciousness, inability to clear airways, arterial blood pH &lt; 7.26, hemodynamic instability, or cor-pulmonale. Patients consented to a 7-day regimen of nebulized corticosteroid (beclomethasone), with ABG parameters like PaO2, PaCO2, and pH measured before and after treatment. Data analysis was performed using SPSS Version 24. Results: Treatment significantly increased mean PaO2 (from 58.78 to 69.41) and decreased mean PaCO2 (from 57.34 to 47.70), with notable improvements across age groups and genders and minimal side effects. Conclusion: Nebulized corticosteroid therapy markedly improved arterial oxygenation and CO2 elimination in AECOPD patients, demonstrating efficacy and safety across demographics. These findings support nebulized corticosteroids as a viable alternative to systemic corticosteroids in AECOPD management.