Objective: To assess the short-term clinical effects of individualized, hardware-assisted airway clearance techniques (ACTs) during acute non cystic fibrosis bronchiectasis (NCFB exacerbations). Methods: In this prospective, controlled cohort study, 46 adults hospitalized with Computed tomography–confirmed bilateral (CT-confirmed bilateral) NCFB were assigned to an intervention group (ACT plus pharmacological therapy; n = 23) or a control group (pharmacological therapy alone; n = 23). ACT modality (intrapulmonary percussive ventilation (IPV), high-frequency chest wall oscillation (HFCWO), or mechanical insufflation–exsufflation (MIE)) was selected based on IPV tolerability and respiratory muscle strength maximum inspiratory pressure Z-score (MIP Z-score). Outcomes included 24-hour sputum volume, dyspnea (modified medical research council dyspnea scale (mMRC), Borg), spirometry, inflammatory markers, and length of hospital stay. Results: Compared with controls, the intervention group showed greater reductions in sputum volume (–15 vs. –10 mL; p = 0.005) and dyspnea (mMRC –1.0 vs. 0.0; Borg –2.0 vs. –1.0; all p < 0.05), as well as a shorter hospital stay (median 7 vs. 9 days; p < 0.05). There were no differences between groups in spirometric or inflammatory outcomes, and no serious adverse events occurred. Conclusions: Individualized, physiology-guided device-based ACTs improved mucus clearance and dyspnoea during acute NCFB exacerbations and were well tolerated, without short-term spirometric change. Larger studies with longer follow-up are needed to confirm efficacy before routine clinical implementation.
Aminova et al. (Mon,) studied this question.