Airway clearance techniques for people with acute exacerbation of COPD: a scoping review

Introduction Acute exacerbations of COPD (AECOPD) often involve mucus hypersecretion. Thus, management of sputum retention is critical. However, the use of airway clearance techniques (ACTs) in people with AECOPD across different healthcare settings and factors influencing their selection remain unc...

Full description

Saved in:
Bibliographic Details
Main Authors: William Poncin, Christine Schrøder, Ana Oliveira, Beatriz Herrero, Pierre Cnockaert, Lucile Gely, Christian Osadnik, Gregory Reychler, Inger Mechlenburg, Arietta Spinou
Format: Article
Language:English
Published: European Respiratory Society 2025-01-01
Series:European Respiratory Review
Online Access:http://err.ersjournals.com/content/34/175/240191.full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850098031265841152
author William Poncin
Christine Schrøder
Ana Oliveira
Beatriz Herrero
Pierre Cnockaert
Lucile Gely
Christian Osadnik
Gregory Reychler
Inger Mechlenburg
Arietta Spinou
author_facet William Poncin
Christine Schrøder
Ana Oliveira
Beatriz Herrero
Pierre Cnockaert
Lucile Gely
Christian Osadnik
Gregory Reychler
Inger Mechlenburg
Arietta Spinou
author_sort William Poncin
collection DOAJ
description Introduction Acute exacerbations of COPD (AECOPD) often involve mucus hypersecretion. Thus, management of sputum retention is critical. However, the use of airway clearance techniques (ACTs) in people with AECOPD across different healthcare settings and factors influencing their selection remain unclear. Objective To identify and map ACTs used for AECOPD in different healthcare settings and the factors influencing clinical decision-making worldwide. Methods Four electronic databases and grey literature were searched from 1995 to December 2023, with hand-searching of eligible records. The Joanna Briggs Institute methodology for scoping reviews was followed. Results 25 articles were included: 14 clinical studies, five guidelines/statements and six surveys/audits. Clinical studies reported the use of a wide range of single or combined ACTs, with no clear pattern in using particular ACTs in different parts of the world. Recent guidelines advise using ACTs for certain patients with AECOPD, particularly those with hypersecretion, with most guidelines recommending positive expiratory pressure (PEP) therapy. According to surveys, the most used ACTs in Australia and Europe are active cycle of breathing techniques, PEP or forced expiratory technique, while vibrations are most frequently used in Canada. Factors influencing the selection of specific ACTs include the presence of contraindications, level of dyspnoea, access to resources/equipment and ease of learning/performing the technique. All information was derived from hospital settings. Conclusions This scoping review identified and mapped ACTs used for people with AECOPD worldwide and their decision-making factors. Future work should focus on community settings.
format Article
id doaj-art-906e469846804d8d90f92ee682bc228a
institution DOAJ
issn 0905-9180
1600-0617
language English
publishDate 2025-01-01
publisher European Respiratory Society
record_format Article
series European Respiratory Review
spelling doaj-art-906e469846804d8d90f92ee682bc228a2025-08-20T02:40:48ZengEuropean Respiratory SocietyEuropean Respiratory Review0905-91801600-06172025-01-013417510.1183/16000617.0191-20240191-2024Airway clearance techniques for people with acute exacerbation of COPD: a scoping reviewWilliam Poncin0Christine Schrøder1Ana Oliveira2Beatriz Herrero3Pierre Cnockaert4Lucile Gely5Christian Osadnik6Gregory Reychler7Inger Mechlenburg8Arietta Spinou9 Pole of Pulmonology, ENT and Dermatology (LUNS), Institute of Experimental and Clinical Research (IREC), Université Catholique de Louvain (UCLouvain), Brussels, Belgium Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus, Denmark Respiratory Research and Rehabilitation Laboratory (Lab3R), School of Health Sciences (ESSUA), University of Aveiro, Aveiro, Portugal Universidad San Jorge, Zaragoza, Spain Pole of Pulmonology, ENT and Dermatology (LUNS), Institute of Experimental and Clinical Research (IREC), Université Catholique de Louvain (UCLouvain), Brussels, Belgium Pole of Pulmonology, ENT and Dermatology (LUNS), Institute of Experimental and Clinical Research (IREC), Université Catholique de Louvain (UCLouvain), Brussels, Belgium Department of Physiotherapy, Monash University, Monash, Australia Pole of Pulmonology, ENT and Dermatology (LUNS), Institute of Experimental and Clinical Research (IREC), Université Catholique de Louvain (UCLouvain), Brussels, Belgium Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus, Denmark Population Health Sciences, King's College London, London, UK Introduction Acute exacerbations of COPD (AECOPD) often involve mucus hypersecretion. Thus, management of sputum retention is critical. However, the use of airway clearance techniques (ACTs) in people with AECOPD across different healthcare settings and factors influencing their selection remain unclear. Objective To identify and map ACTs used for AECOPD in different healthcare settings and the factors influencing clinical decision-making worldwide. Methods Four electronic databases and grey literature were searched from 1995 to December 2023, with hand-searching of eligible records. The Joanna Briggs Institute methodology for scoping reviews was followed. Results 25 articles were included: 14 clinical studies, five guidelines/statements and six surveys/audits. Clinical studies reported the use of a wide range of single or combined ACTs, with no clear pattern in using particular ACTs in different parts of the world. Recent guidelines advise using ACTs for certain patients with AECOPD, particularly those with hypersecretion, with most guidelines recommending positive expiratory pressure (PEP) therapy. According to surveys, the most used ACTs in Australia and Europe are active cycle of breathing techniques, PEP or forced expiratory technique, while vibrations are most frequently used in Canada. Factors influencing the selection of specific ACTs include the presence of contraindications, level of dyspnoea, access to resources/equipment and ease of learning/performing the technique. All information was derived from hospital settings. Conclusions This scoping review identified and mapped ACTs used for people with AECOPD worldwide and their decision-making factors. Future work should focus on community settings.http://err.ersjournals.com/content/34/175/240191.full
spellingShingle William Poncin
Christine Schrøder
Ana Oliveira
Beatriz Herrero
Pierre Cnockaert
Lucile Gely
Christian Osadnik
Gregory Reychler
Inger Mechlenburg
Arietta Spinou
Airway clearance techniques for people with acute exacerbation of COPD: a scoping review
European Respiratory Review
title Airway clearance techniques for people with acute exacerbation of COPD: a scoping review
title_full Airway clearance techniques for people with acute exacerbation of COPD: a scoping review
title_fullStr Airway clearance techniques for people with acute exacerbation of COPD: a scoping review
title_full_unstemmed Airway clearance techniques for people with acute exacerbation of COPD: a scoping review
title_short Airway clearance techniques for people with acute exacerbation of COPD: a scoping review
title_sort airway clearance techniques for people with acute exacerbation of copd a scoping review
url http://err.ersjournals.com/content/34/175/240191.full
work_keys_str_mv AT williamponcin airwayclearancetechniquesforpeoplewithacuteexacerbationofcopdascopingreview
AT christineschrøder airwayclearancetechniquesforpeoplewithacuteexacerbationofcopdascopingreview
AT anaoliveira airwayclearancetechniquesforpeoplewithacuteexacerbationofcopdascopingreview
AT beatrizherrero airwayclearancetechniquesforpeoplewithacuteexacerbationofcopdascopingreview
AT pierrecnockaert airwayclearancetechniquesforpeoplewithacuteexacerbationofcopdascopingreview
AT lucilegely airwayclearancetechniquesforpeoplewithacuteexacerbationofcopdascopingreview
AT christianosadnik airwayclearancetechniquesforpeoplewithacuteexacerbationofcopdascopingreview
AT gregoryreychler airwayclearancetechniquesforpeoplewithacuteexacerbationofcopdascopingreview
AT ingermechlenburg airwayclearancetechniquesforpeoplewithacuteexacerbationofcopdascopingreview
AT ariettaspinou airwayclearancetechniquesforpeoplewithacuteexacerbationofcopdascopingreview