Airway clearance

Keeping the airways as free of secretions as possible is an important part of bronchiectasis management. Airway clearance methods include physical techniques and drug treatment.

Refer to a respiratory physiotherapist with expertise in bronchiectasis to develop an individualised airway clearance program. Physical methods may include various breathing and coughing techniques, and the use of aids for sputum mobilisation (eg mechanical devices). Information and videos on different airway clearance techniques can be found on the Bronchiectasis Toolbox website.

Inhaled and nebulised mucolytic agents that may assist with airway clearance include normal and hypertonic saline (sodium chloride solution). Nebulised hypertonic saline may cause bronchospasm in susceptible patients; refer to a specialist respiratory laboratory for hypertonic saline challenge before starting. Bronchodilators are sometimes used as pretreatment before mucolytics to prevent bronchoconstriction and improve pulmonary deposition.