RT Journal Article SR Electronic T1 Cystic Fibrosis Pulmonary Guidelines: Airway Clearance Therapies JF Respiratory Care FD American Association for Respiratory Care SP 522 OP 537 VO 54 IS 4 A1 Patrick A Flume A1 Karen A Robinson A1 Brian P O'Sullivan A1 Jonathan D Finder A1 Robert L Vender A1 Donna-Beth Willey-Courand A1 Terry B White A1 Bruce C Marshall A1 the Clinical Practice Guidelines for Pulmonary Therapies Committee YR 2009 UL http://rc.rcjournal.com/content/54/4/522.abstract AB Cystic fibrosis (CF) is a genetic disease characterized by dehydration of airway surface liquid and impaired mucociliary clearance. As a result, there is difficulty clearing pathogens from the lung, and patients experience chronic pulmonary infections and inflammation. Clearance of airway secretions has been a primary therapy for those with CF, and a variety of airway clearance therapies (ACTs) have been developed. Because ACTs are intrusive and require considerable time and effort, it is important that appropriate techniques are recommended on the basis of available evidence of efficacy and safety. Therefore, the Cystic Fibrosis Foundation established a committee to examine the clinical evidence for each therapy and provide guidance for their use. A systematic review was commissioned, which identified 7 unique reviews and 13 additional controlled trials that addressed one or more of the comparisons of interest and were deemed eligible for inclusion. Recommendations for use of the ACTs were made, balancing the quality of evidence and the potential harms and benefits. The committee determined that, although there is a paucity of controlled trials that assess the long-term effects of ACTs, the evidence quality overall for their use in CF is fair and the benefit is moderate. The committee recommends airway clearance be performed on a regular basis in all patients. There are no ACTs demonstrated to be superior to others, so the prescription of ACTs should be individualized. Aerobic exercise is recommended as an adjunctive therapy for airway clearance and for its additional benefits to overall health.