References

pulmo

Пульмонология

PULMONOLOGIYA

0869-01892541-9617

Scientific and Practical Journal “PULMONOLOGIYA” LLC

10.18093/0869-0189-2018-28-2-147-168

pulmo-981

Research Article

КЛИНИЧЕСКИЕ РЕКОМЕНДАЦИИ

CLINICAL GUIDELINES

Бронхоэктазы у взрослых больных: клинические рекомендации Европейского респираторного общества

Adult patients with bronchiectasis: clinical guideline of European Respiratory Society

Редакционная

статья

Editorial

Article

2018

30062018

282147168

2018

Редакционная с.

Editorial a.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://journal.pulmonology.ru/pulm/article/view/981

Бронхоэктазы (БЭ) у взрослых – это хроническое заболевание, связанное с низким качеством жизни (КЖ), а в большинстве случаев – с частыми обострениями. До настоящего времени международные клинические рекомендации по этой проблеме отсутствовали. В клинических рекомендациях Европейского респираторного общества по ведению взрослых пациентов с БЭ содержатся описания клинических исследований и терапевтического подхода, основанного на систематическом обзоре опубликованных данных. Экспертами многопрофильной группы, состоящей из пульмонологов, микробиологов, специалистов по лечебной физкультуре, торакальных хирургов, врачей первичного звена, методистов и пациентов, отобраны 9 наиболее важных (как для врачей, так и для пациентов) клинических проблем, относящихся к теме БЭ. По этим проблемам в литературе проведен поиск клинических и наблюдательных исследований, а также систематических обзоров, на основании которых выполнен систематический обзор. Для определения качества доказательств и уровня рекомендаций использовалась система GRADE. В данных клинических рекомендациях рассматриваются вопросы установления этиологии БЭ, терапии обострений, эрадикации возбудителей, длительной антибактериальной, противовоспалительной, мукоактивной и бронхолитической терапии, хирургического лечения и лечебной физкультуры. Данные рекомендации могут применяться для сравнительной оценки КЖ лиц с БЭ в странах Европы и улучшения исходов указанного заболевания.

Adult patients with bronchiectasis typically have poor quality of life and mostly frequent exacerbations. This is the first international guideline on this topic. This guideline is based on systematic search of published literature including clinical trials, systematic reviews, and observational studies. A multidisciplinary group of specialists including respiratory physicians, microbiologists, physiotherapeutists, thoracic surgeons, primary care physicians, methodologists and patients developed the guidelines on nine most important clinical questions relevant to bronchiectasis. The GRADE system was used to define the quality of the evidence and the level of recommendations. The guideline covers causes of bronchiectasis, management of exacerbations, pathogen eradication, long term antibiotic treatment, anti-inflammatory treatment, mucoactive drugs, bronchodilators, surgical treatment and physiotherapy.

бронхоэктазывзрослыеантибактериальная терапияобостренияэрадикация возбудителяхирургическое лечениелечебная физкультура

bronchiectasisadultsantibacterial treatmentexacerbationpathogen eradicationsurgical treatmentphysiotherapy

References1

Winter D.H., Manzini M., Salge J.M. et al. Aging of the lungs in asymptomatic lifelong nonsmokers: findings on. HRCT. Lung. 2015; 193 (2): 283–290. DOI: 10.1007/s00408-015-9700-3.

Brozek J.L., Akl E.A., Compalati E. et al. Grading quality of evidence and strength of recommendations in clinical practice guidelinesPart 3 of 3. The GRADE approach to developingrecommendations. Allergy. 2011; 66 (5): 588–595. DOI: 10.1111/j.1398-9995.2010.02530.x.

Andrews J., Guyatt G., Oxman A.D. et al. GRADE guidelines: 14. Going from evidence to recommendations: The significance and presentation of recommendations. J. Clin. Epidemiol. 2013; 66 (7): 719–725. DOI: 10.1016/j.jclinepi.2012.03.013.

King P.T., Holdsworth S.R., Freezer N.J. et al. Characterisation of the onset and presenting clinical features of adult bronchiectasis. Respir. Med. 2006; 100 (12): 2183–2189. DOI: 10.1016/j.rmed.2006.03.012.

Raghu G., King T.E., Behr J. et al. Quality of life and dyspnoea in patients treated with bosentan for idiopathic pulmonary fibrosis (BUILD-1). Eur. Respir. J. 2010; 35 (1): 118–123. DOI: 10.1183/09031936.00188108.

Tashkin D.P., Celli B., Senn S. et al. A 4-year trial of tiotropium in chronic obstructive pulmonary disease. N. Engl. J. Med. 2008; 359 (15): 1543–1554. DOI: 10.1056/NEJMoa0805800.

Chalmers J.D., Smith M.P., McHugh B.J. et al. Short- and long-term antibiotic treatment reduces airway and systemic inflammation in non-cystic fibrosis bronchiectasis. Am. J. Respir. Crit. Care Med. 2012; 186 (7): 657–665. DOI: 10.1164/rccm.201203-0487OC.

Sheehan R.E., Wells A.U., Copley S.J. et al. A comparison of serial computed tomography and functional change in bronchiectasis. Eur. Respir. J. 2002; 20: 581–587. DOI: 10.1183/09031936.02.00284602.

Chalmers J.D., Goeminne P., Aliberti S. et al. The bronchiectasis severity index. An international derivation and validation study. Am. J. Respir. Crit. Care Med. 2014; 189 (5): 576–585. DOI: 10.1164/rccm.201309-1575OC.

Aliberti S., Lonni S., Dore S. et al. Clinical phenotypes in adult patients with bronchiectasis. Eur. Respir. J. 2016; 47 (4): 1113–1122. DOI: 10.1183/13993003.01899-2015.

Kapur N., Masters I.B., Chang A.B. Longitudinal growth and lung function in pediatric non-cystic fibrosis bronchiectasis: What influences lung function stability? Chest. 2010; 138 (1): 158–164. DOI: 10.1378/chest.09-2932.

Chalmers J.D., Aliberti S., Polverino E. et al. The EMBARC European Bronchiectasis Registry: protocol for an international observational study. ERJ Open Res. 2016; 2 (1): 00081–2015. DOI: 10.1183/23120541.00081-2015.

Loebinger M.R., Wells A.U., Hansell D.M. et al. Mortality in bronchiectasis: a long-term study assessing the factors influencing survival. Eur. Respir. J. 2009; 34 (4): 843–849. DOI: 10.1183/09031936.00003709.

McDonnell M.J., Aliberti S., Goeminne P.C. et al. Multidimensional severity assessment in bronchiectasis: an analysis of seven European cohorts. Thorax. 2016; 71 (12): 1110–1118. DOI: 10.1136/thoraxjnl-2016-208481.

Finch S., McDonnell M.J., Abo-Leyah H. et al. A comprehensive analysis of the impact of Pseudomonas aeruginosa colonization on prognosis in adult bronchiectasis. Ann. Am. Thorac. Soc. 2015; 12 (11): 1602–1611. DOI: 10.1513/AnnalsATS.201506-333OC.

Wilson C.B., Jones P.W., O’Leary C.J. et al. Systemic markers of inflammation in stable bronchiectasis. Eur. Respir. J. 1998; 12 (4): 820–824. DOI: 10.1183/09031936.98.12040820.

Tsang K.W., Chan K.N., Ho P.L. et al. Sputum elastase in steady-state bronchiectasis. Chest. 2000; 117 (2): 420–426. DOI: 10.1378/chest.117.2.420.

Chalmers J.D., Moffitt K.L., Suarez-Cuartin G. et al. Neutrophil elastase activity is associated with exacerbations and lung function decline in bronchiectasis. Am. J. Respir. Crit. Care Med. 2017; 195 (10): 1384–1393. DOI: 10.1164/rccm.201605-1027OC.

Chalmers J.D., Hill A.T. Mechanisms of immune dysfunction and bacterial persistence in non-cystic fibrosis bronchiectasis. Mol. Immunol. 2013; 55 (1): 27–34. DOI: 10.1016/j.molimm.2012.09.011.

Snijders D., Dominguez B.F., Calgaro S. et al. Mucociliary clearance techniques for treating non-cystic fibrosis bronchiectasis: Is there evidence? Int. J. Immunopathol. Pharmacol. 2015; 28 (2): 150–159. DOI: 10.1177/0394632015584724.

McDonnell M.J., Aliberti S., Goeminne P.C. et al. Comorbidities and the risk of mortality in patients with bronchiectasis: an international multicentre cohort study. Lancet Respir. Med. 2016; 4 (12): 969–979. DOI: 10.1016/S2213-2600(16)30320-4.

Du Q., Jin J., Liu X.et al. Bronchiectasis as a comorbidity of chronic obstructive pulmonary disease: A systematic review and meta-analysis. PLoS One. 2016; 11 (3): e0150532. DOI: 10.1371/journal.pone.0150532.

Navaratnam V., Muirhead C.R., Hubbard R.B. et al. Critical care admission trends and outcomes in individuals with bronchiectasis in the UK. Q. J. Med. 2016; 109 (8): 523–526. DOI: 10.1093/qjmed/hcv206.

Navaratnam V., Millett E.R., Hurst J.R. et al. Bronchiectasis and the risk of cardiovascular disease: a population-based study. Thorax. 2017; 72 (2): 161–166. DOI: 10.1136/thoraxjnl-2015-208188.

Ringshausen F.C., de Roux A., Pletz M.W. et al. Bronchiectasis-associated hospitalizations in Germany, 2005–2011: a population-based study of disease burden and trends. PLoS One. 2013; 8 (8): e71109. DOI: 10.1371/journal.pone.0071109.

Weycker D., Edelsberg J., Oster G. et al. Prevalence and economic burden of bronchiectasis. Clin. Pulm. Med. 2005; 12 (4): 205–209. DOI: 10.1097/01.cpm.0000171422.98696.ed.

Kwak H.J., Moon J.Y., Choi Y.W. et al. High prevalence of bronchiectasis in adults: analysis of CT findings in a health screening program. Tohoku J. Exp. Med. 2010; 222 (4): 237–242. DOI: 10.1620/tjem.222.237.

Quint J.K., Millett E.R., Joshi M. et al. Changes in the incidence, prevalence and mortality of bronchiectasis in the UK from 2004 to 2013: A population-based cohort study. Eur. Respir. J. 2016; 47 (1): 186–193. DOI: 10.1183/13993003.01033-2015.

Chang A.B., Grimwood K., Mulholland E.K. et al. Bronchiectasis in Indigenous children in remote Australian communities. Med. J. Aust. 2002; 177 (4): 200–204.

Seitz A.E., Olivier K.N., Steiner C.A. et al. Trends and burden of bronchiectasis-associated hospitalizations in the United States, 1993–2006. Chest. 2010; 138 (4): 944–949. DOI: 10.1378/chest.10-0099.

Finklea J.D., Khan G., Thomas S. et al. Predictors of mortality in hospitalized patients with acute exacerbation of bronchiectasis. Respir. Med. 2010; 104 (6): 816–821. DOI: 10.1016/j.rmed.2009.11.021.

Goeminne P.C., Nawrot T.S., Ruttens D. et al. Mortality in non-cystic fibrosis bronchiectasis: a prospective cohort analysis. Respir. Med. 2014; 108 (2): 287–296. DOI: 10.1016/j.rmed.2013.12.015.

de la Rosa D., Martinez-Garcia M.A., Olveira C. et al. Annual direct medical costs of bronchiectasis treatment: Impact of severity, exacerbations, chronic bronchial colonization and chronic obstructive pulmonary disease coexistence. Chron. Respir. Dis. 2016; 13 (4): 361–371. DOI: 10.1177/1479972316643698.

Gursel G. Does coexistence with bronchiectasis influence intensive care unit outcome in patients with chronic obstructive pulmonary disease? Heart Lung. 2006; 35 (1): 58–65. DOI: 10.1016/j.hrtlng.2005.04.003.

O’Donnell A.E., Barker A.F., Ilowite J.S. et al. Treatment of idiopathic bronchiectasis with aerosolized recombinant human DNase I. Chest. 1998; 113 (5): 1329–1334. DOI: 10.1378/chest.113.5.1329.

Barker A.F., O’Donnell A.E., Flume P. et al. Aztreonam for inhalation solution in patients with non-cystic fibrosis bronchiectasis (AIR-BX1 and AIR-BX2): Two randomised double-blind, placebo-controlled phase 3 trials. Lancet Respir. Med. 2014; 2 (9): 738–749. DOI: 10.1016/S2213-2600(14)70165-1.

Vendrell M., de Gracia J., Olveira C. et al. Normativa SEPAR: diagnóstico y tratamiento de las bronquiectasias. Arch. Bronconeumol. 2008; 44 (11): 629–640. DOI: 10.1016/S1579-2129(08)60117-2.

Pasteur M.C., Bilton D., Hill A.T., British Thoracic Society Bronchiectasis non-CF Guideline Group. British Thoracic Society guideline for non-CF bronchiectasis. Thorax. 2010; 65 (Suppl. 1): i1–58. DOI: 10.1136/thx.2010.136119.

Woodhead M., Blasi F., Ewig S. et al. Guidelines for the management of adult lower respiratory tract infections–full version. Clin. Microbiol. Infect. 2011; 17 (Suppl. 6): E1–59. DOI: 10.1111/j.1469-0691.2011.03672.x.

Andrews J.C., Schünemann H.J., Oxman A.D. et al. GRADE guidelines: 15. Going from evidence to recommendation–determinants of a recommendation’s direction and strength. J. Clin. Epidemiol. 2013; 66 (7): 726–735. DOI: 10.1016/j.jclinepi.2013.02.003.

Alonso-Coello P., Schünemann H.J., Moberg J. et al. GRADE Evidence to Decision (EtD) frameworks: a systematic and transparent approach to making well informed healthcare choices. 1: Introduction. Br. Med. J. 2016; 353: i2016. DOI: 10.1136/bmj.i2016.

Anwar G.A., McDonnell M.J., Worthy S.A. et al. Phenotyping adults with non-cystic fibrosis bronchiectasis: A prospective observational cohort study. Respir. Med. 2013; 107 (7): 1001–1007. DOI: 10.1016/j.rmed.2013.04.013.

Shoemark A., Ozerovitch L., Wilson R. Aetiology in adult patients with bronchiectasis. Respir. Med. 2007; 101 (6): 1163–1170. DOI: 10.1016/j.rmed.2006.11.008.

Pasteur M.C., Helliwell S.M., Houghton S.J. et al. An investigation into causative factors in patients with bronchiectasis. Am. J. Respir. Crit. Care Med 2000; 162 (4, Pt 1): 1277–1284. DOI: 10.1164/ajrccm.162.4.9906120.

Lonni S., Chalmers J.D., Goeminne P.C. et al. Etiology of non-cystic fibrosis bronchiectasis in adults and its correlation to disease severity. Ann. Am. Thorac. Soc. 2015; 12 (12): 1764–1770. DOI: 10.1513/AnnalsATS.201507-472OC.

Greenberger P.A. When to suspect and work up allergic bronchopulmonary aspergillosis. Ann. Allergy Asthma Immunol. 2013; 111 (1): 1–4. DOI: 10.1016/j.anai.2013.04.014.

Knutsen A.P., Bush R.K., Demain J.G. et al. Fungi and allergic lower respiratory tract diseases. J. Allergy Clin. Immunol. 2012; 129 (2): 280–291. DOI: 10.1016/j.jaci.2011.12.970.

Griffith D.E., Aksamit T., Brown-Elliott B.A. et al. An official ATS/IDSA statement: Diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases. Am. J. Respir. Crit. Care Med. 2007; 175 (4): 367–416. DOI: 10.1164/rccm.200604-571ST.

Lucas J.S., Barbato A., Collins S.A. et al. European Respiratory Society guidelines for the diagnosis of primary ciliary dyskinesia. Eur. Respir. J. 2017; 49 (1): 1601090. DOI: 10.1183/13993003.01090-2016.

Bilton D., Henig N., Morrissey B. et al. Addition of inhaled tobramycin to ciprofloxacin for acute exacerbations of Pseudomonas aeruginosa infection in adult bronchiectasis. Chest. 2006; 130 (5): 1503–1510. DOI: 10.1378/chest.130.5.1503.

Murray M.P., Turnbull K., MacQuarrie S. et al. Assessing response to treatment of exacerbations of bronchiectasis in adults. Eur. Respir. J. 2009; 33 (2): 312–317. DOI: 10.1183/09031936.00122508.

Orriols R., Roe J. Inhaled antibiotic therapy in non-cystic fibrosis patients with bronchiectasis and chronic broncial infection by Pseudomonas aeruginosa. Respir. Med. 1999; 93 (7): 476–480.

McDonnell M.J., Jary H.R., Perry A. et al. Non cystic fibrosis bronchiectasis: a longitudinal retrospective observational cohort study of Pseudomonas persistence and resistance. Respir. Med. 2015; 109 (6): 716–726. DOI: 10.1016/j.rmed.2014.07.021.

Orriols R., Hernando R., Ferrer A. et al. Eradication therapy against Pseudomonas aeruginosa in non-cystic fibrosis bronchiectasis. Respiration. 2015; 90 (4): 299–305. DOI: 10.1159/000438490.

White L., Mirrani G., Grover M. et al. Outcomes of Pseudomonas eradication therapy in patients with non-cystic fibrosis bronchiectasis. Respir. Med. 2012; 106 (3): 356–360. DOI: 10.1016/j.rmed.2011.11.018.

Goyal V., Chang A.B. Combination inhaled corticosteroids and long-acting beta2-agonists for children and adults with bronchiectasis. Cochrane Database Syst. Rev. 2014; (6): CD010327. DOI: 10.1002/14651858.CD010327.pub2.

Steele K., Greenstone M., Lasserson J.A. Oral methyl-xanthines for bronchiectasis. Cochrane Database Syst. Rev. 2001; (1): CD002734. DOI: 10.1002/14651858.CD002734.

Lasserson T., Holt K. Oral corticosteroids for bronchiectasis (stable and acute exacerbations). Cochrane Database Syst. Rev. 2001; (4): CD002162. DOI: 10.1002/14651858.CD002162.

Corless J.A., Warburton C.J. Leukotriene receptor antagonists for non-cystic fibrosis bronchiectasis. Cochrane Database Syst. Rev. 2000; (4): CD002174. DOI: 10.1002/14651858.CD002174.

Kapur N., Chang A.B. Oral non steroid anti-inflammatories for children and adults with bronchiectasis. Cochrane Database Syst. Rev. 2007; (4): CD006427. DOI: 10.1002/14651858.CD006427.pub2.

Pizzutto S.J., Upham J.W., Yerkovich S.T. et al. Inhaled non-steroid anti-inflammatories for children and adults with bronchiectasis. Cochrane Database Syst. Rev. 2016; (1): CD007525. DOI: 10.1002/14651858.CD007525.pub3.

Tsang K.W., Tan K.C., Ho P.L. et al. Inhaled fluticasone in bronchiectasis: a 12 month study. Thorax. 2005; 60 (3): 239–243. DOI: 10.1136/thx.2002.003236.

Mandal P., Chalmers J.D., Graham C. et al. Atorvastatin as a stable treatment in bronchiectasis: A randomized controlled trial. Lancet Respir. Med. 2014; 2 (6): 455–463. DOI: 10.1016/S2213-2600(14)70050-5.

Hernando R., Drobnic M.E., Cruz M.J. et al. Budesonide efficacy and safety in patients with bronchiectasis not due to cystic fibrosis. Int. J. Clin. Pharm. 2012; 34 (4): 644–650. DOI: 10.1007/s11096-012-9659-6.

Brodt A.M., Stovold E., Zhang L. Inhaled antibiotics for stable non-cystic fibrosis bronchiectasis: a systematic review. Eur. Respir. J. 2014; 44 (2): 382–393. DOI: 10.1183/09031936.00018414.

Gao Y., Guan W., Xu G. et al. Macrolide therapy in adults and children with non-cystic fibrosis bronchiectasis: a systematic review and meta-analysis. PLoS One. 2014; 9 (3): e90047. DOI: 10.1371/journal.pone.0090047.

Shi Z.L., Peng H., Hu X.W. et al. Effectiveness and safety of macrolides in bronchiectasis patients: a meta-analysis and systematic review. Pulm. Pharmacol. Ther. 2014; 28 (2): 171–178. DOI: 10.1016/j.pupt.2013.09.003.

Wu Q., Shen W., Cheng H. et al. Long-term macrolides for non-cystic fibrosis bronchiectasis: A systematic review and meta-analysis. Respirology. 2014; 19 (3): 321–329. DOI: 10.1111/resp.12233.

Zhuo G.Y., He Q., Xiang-Lian L. et al. Prolonged treatment with macrolides in adult patients with non-cystic fibrosis bronchiectasis: Meta-analysis of randomized controlled trials. Pulm. Pharmacol. Ther. 2014; 29 (1): 80–88. DOI: 10.1016/j.pupt.2014.02.002.

Fan L.C., Lu H.W., Wei P. et al. Effects of long-term use of macrolides in patients with non-cystic fibrosis bronchiectasis: a meta-analysis of randomized controlled trials. BMC Infect. Dis. 2015; 27 (15): 160. DOI: 10.1186/s12879-015-0872-5.

Yang J.W., Fan L.C., Lu H.W. et al. Efficacy and safety of long-term inhaled antibiotic for patients with noncystic fibrosis bronchiectasis: a meta-analysis. Clin. Respir. J. 2016; 10 (6): 731–739. DOI: 10.1111/crj.12278.

Hnin K., Nguyen C., Carson K.V. et al. Prolonged antibiotics for non-cystic fibrosis bronchiectasis in children and adults. Cochrane Database Syst. Rev. 2015; (8): CD001392.DOI: 10.1002/14651858.CD001392.pub3.

Currie D.C., Garbett N.D., Chan K.L. et al. Double-blind randomized study of prolonged higher-dose oral amoxycillin in purulent bronchiectasis. Q. J. Med. 1990; 76 (280): 799–816.

Cymbala A.A., Edmonds L.C., Bauer M.A. et al. The disease-modifying effects of twice-weekly oral azithromycin in patients with bronchiectasis. Treat. Respir. Med. 2005; 4 (2): 117–122.

Drobnic M.E., Suñé P., Montoro J.B. et al. Inhaled tobramycin in non-cystic fibrosis patients with bronchiectasis and chronic bronchial infection with Pseudomonas aeruginosa. Ann. Pharmacother. 2005; 39 (1): 39–44. DOI: 10.1345/aph.1E099.

Murray M.P., Govan J.R.W., Doherty C.J. et al. A randomized controlled trial of nebulized gentamicin in non-cystic fibrosis bronchiectasis. Am. J. Respir. Crit. Care Med. 2011; 183 (4): 491–499. DOI: 10.1164/rccm.201005-0756OC.

Wong C., Jayaram L., Karalus N. et al. Azithromycin for prevention of exacerbations in non-cystic fi brosis bronchiectasis (EMBRACE): A randomised, double-blind, placebo-controlled trial. Lancet. 2012; 380 (9842): 660–667. DOI: 10.1016/S0140-6736(12)60953-2.

Serisier D.J., Bilton D., De Soyza A. et al. Inhaled, dual release liposomal ciprofloxacin in non-cystic fibrosis bronchiectasis (ORBIT-2): a randomised, double-blind, placebo-controlled trial. Thorax. 2013; 68 (9): 812–817. DOI: 10.1136/thoraxjnl-2013-203207.

Serisier D.J., Martin M.L., McGuckin M.A. et al. Effect of long-term, low-dose erythromycin on pulmonary exacerbations among patients with non-cystic fibrosis bronchiectasis: the BLESS randomized controlled trial. JAMA. 2013; 309 (12): 1260–1267. DOI: 10.1001/jama.2013.2290.

Altenburg J. Effect of azithromycin maintenance treatment on infectious exacerbations among patients with non–cystic fibrosis bronchiectasis. JAMA. 2013; 309 (12): 1251–1259. DOI: 10.1001/jama.2013.1937.

De Diego A., Milara J., Martinez-Moragón E. et al. Effects of long-term azithromycin therapy on airway oxidative stress markers in non-cystic fibrosis bronchiectasis. Respirology. 2013; 18 (7): 1056–1062. DOI: 10.1111/resp.12130.

Tabernero Huguet E., Gil Alaña P., Alkiza Basañez R. et al. [Inhaled colistin in elderly patients with non-cystic fibrosis bronchiectasis and chronic Pseudomonas aeruginosa bronchial infection]. Rev. Esp. Geriatr. Gerontol. 2015; 50 (3): 111–115. DOI: 10.1016/j.regg.2014.09.005 (in Spanish).

Haworth C.S., Foweraker J.E., Wilkinson P. et al. Inhaled colistin in patients with bronchiectasis and chronic Pseudomonas aeruginosa infection. Am. J. Respir. Crit. Care Med. 2014; 189 (8): 975–982. DOI: 10.1164/rccm.201312-2208OC.

PROLONGED antibiotic treatment of severe bronchiectasis; a report by a subcommittee of the Antibiotics Clinical Trials (non-tuberculous) Committee of the Medical Research Council. Br. Med. J. 1957; 2 (5039): 255–259.

Lourdesamy A.I., Muthukumaru U. Efficacy of azithromycin in the treatment of bronchiectasis. Respirology. 2014; 19 (8): 1178–1182. DOI: 10.1111/resp.12375.

Liu J., Zhong X., He Z. et al. Effect of Low-Dose, long-term roxithromycin on airway inflammation and remodeling of stable noncystic fibrosis bronchiectasis. Mediators Inflamm. 2014; 2014: 708608. DOI: 10.1155/2014/708608.

Barker A.F., Couch L., Fiel S.B. et al. Tobramycin solution for inhalation reduces sputum Pseudomonas aeruginosa density in bronchiectasis. Am. J. Respir. Crit. Care Med. 2000; 162 (2, Pt 1): 481–485. DOI: 10.1164/ajrccm.162.2.9910086.

Hart A., Sugumar K., Milan S.J. et al. Inhaled hyperosmolar agents for bronchiectasis. Cochrane Database Syst. Rev. 2014; (5): CD002996. DOI: 10.1002/14651858.CD002996.pub3.

Wilkinson M., Sugumar K., Milan S.J. et al. Mucolytics for bronchiectasis. Cochrane Database Syst. Rev. 2014; (5): CD001289. DOI: 10.1002/14651858.CD001289.pub2.

Wills P., Greenstone M. Inhaled hyperosmolar agents for bronchiectasis. Cochrane Database Syst. Rev. 2002; (2): CD002996. DOI: 10.1002/14651858.CD002996.

Nicolson C.H.H., Stirling R.G., Borg B.M. et al. The long term effect of inhaled hypertonic saline 6% in non-cystic fibrosis bronchiectasis. Respir. Med. 2012; 106 (5): 661–667. DOI: 10.1016/j.rmed.2011.12.021.

Kellett F., Robert N.M. Nebulised 7% hypertonic saline improves lung function and quality of life in bronchiectasis. Respir. Med. 2011; 105 (12): 1831–1835. DOI: 10.1016/j.rmed.2011.07.019.

Bilton D., Daviskas E., Anderson D. et al. Phase 3 randomized study of the efficacy and safety of inhaled dry powder mannitol for the symptomatic treatment of non-cystic fibrosis bronchiectasis. Chest. 2013; 144 (1): 215–225. DOI: 10.1378/chest.12-1763.

Bilton D., Tino G., Barker A.F.,et al. Inhaled mannitol for non-cystic fibrosis bronchiectasis: a randomised, controlled trial. Thorax. 2014; 69 (12): 1073–1079. DOI: 10.1136/thoraxjnl-2014-205587.

Vogelmeier C.F., Criner G.J., Martinez F.J. et al. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease 2017 Report: GOLD Executive Summary. Eur. Respir. J. 2017; 49 (3): 1700214. DOI: 10.1183/13993003.00214-2017.

Reddel H.K., Bateman E.D., Becker A. et al. A summary of the new GINA strategy: A roadmap to asthma control. Eur. Respir. J. 2015; 46 (3): 622–639. DOI: 10.1183/13993003.00853-2015.

Martínez-García M.Á., Soler-Cataluña J.J., Catalán-Serra P. et al. Clinical efficacy and safety ofbudesonide-formoterol in non-cystic fibrosis bronchiectasis. Chest. 2012; 141 (2): 461–468. DOI: 10.1378/chest.11-0180.

Fan L.C., Liang S., Lu H.W. et al. Efficiency and safety of surgical intervention to patients with non-cystic fibrosis bronchiectasis: a meta-analysis. Sci. Rep. 2015; 2 (5): 17382. DOI: 10.1038/srep17382.

Hiramatsu M., Shiraishi Y., Nakajima Y. et al. Risk factors that affect the surgical outcome in the management of focal bronchiectasis in a developed country. Ann. Thorac. Surg. 2012; 93 (1): 245–250. DOI: 10.1016/j.athoracsur.2011.08.077.

100

Hoffman E. The late results of the conservation of the apical segment of the lower lobe in resections for bronchiectasis. Thorax. 1955; 10 (2): 137–141. DOI: 10.1136/thx.10.2.137.

101

Collis J. Fate of the lower apical segment in resections for bronchiectasis. Thorax. 1953; 8 (4): 323–325. DOI: 10.1136/thx.8.4.323.

102

Tanaka H., Matsumura A., Okumura M. et al. Pneumonectomy for unilateral destroyed lung with pulmonary hypertension due to systemic blood flow through broncho-pulmonary shunts. Eur. J. Cardiothorac. Surg. 2005; 28 (3): 389–393. DOI: 10.1016/j.ejcts.2005.04.044.

103

Gourin A., Garzon A.A. Operative treatment of massive hemoptysis. Ann. Thorac. Surg. 1974; 18 (1): 52–60.

104

Schneiter D., Meyer N., Lardinois D. et al. Surgery for non-localized bronchiectasis. Br. J. Surg. 2005; 92 (7): 836–839. DOI: 10.1002/bjs.4949.

105

Zhang P., Zhang F., Jiang S. et al. Video-assisted thoracic surgery for bronchiectasis. Ann. Thorac. Surg. 2011; 91 (1): 239–243. DOI: 10.1016/j.athoracsur.2010.08.035.

106

Lee A.L., Burge A.T., Holland A.E. Airway clearance techniques for bronchiectasis. Cochrane Database Syst. Rev. 2015; (11): CD008351. DOI: 10.1002/14651858.CD008351.pub3.

107

Bradley J., Moran F., Greenstone M. Physical training for bronchiectasis. Cochrane Database Syst. Rev. 2002; (2): CD002166. DOI: 10.1002/14651858.CD002166.

108

Guimarães F.S., Moço V.J.R., Menezes S.L.S. et al. Effects of ELTGOL and Flutter VRP1® on the dynamic and static pulmonary volumes and on the secretion clearance of patients with bronchiectasis. Rev. Bras. Fisioter. 2012; 16 (2): 108–113. DOI: 10.1590/S1413-35552012005000016.

109

Nicolini A., Cardini F., Landucci N. et al. Effectiveness of treatment with high-frequency chest wall oscillation in patients with bronchiectasis. BMC Pulm. Med. 2013; 4 (13): 21. DOI: 10.1186/1471-2466-13-21.

110

Eaton T., Young P., Zeng I. et al. A randomized evaluation of the acute efficacy, acceptability and tolerability of flutter and active cycle of breathing with and without postural drainage in non-cystic fibrosis bronchiectasis. Chron. Respir. Dis. 2007; 4 (1): 23–30. DOI; 10.1177/1479972306074481.

111

Naraparaju S., Vaishali K., Venkatesan P. et al. A comparison of the Acapella and a threshold inspiratory muscle trainer for sputum clearance in bronchiectasis – a pilot study. Physiother. Theory Pract. 2010; 26 (6): 353–357. DOI: 10.3109/09593981003596616.

112

Figueiredo P.H., Zin W.A., Guimarães F.S. Flutter valve improves respiratory mechanics and sputum production in patients with bronchiectasis. Physiother. Res. Int. 2012; 17 (1): 12–20. DOI: 10.1002/pri.507.

113

Patterson J.E., Bradley J.M., Hewitt O. et al. Airway clearance in bronchiectasis: A randomized crossover trial of active cycle of breathing techniques versus acapella? Respiration. 2005; 72 (3): 239–242. DOI: 10.1159/000085363.

114

Murray M.P., Pentland J.L., Hill A.T. A randomised crossover trial of chest physiotherapy in non-cystic fibrosis bronchiectasis. Eur. Respir. J. 2009; 34 (5): 1086–1092. DOI: 10.1183/09031936.00055509.

115

Faulkner J., Gerhard J., Stoner L. et al. Self-paced walking within a diverse topographical environment elicits an appropriate training stimulus for cardiac rehabilitation patients. Rehabil. Res. Pract. 2012; 2012: 140871. DOI: 10.1155/2012/140871.

116

Lee A.L., Hill C.J., Cecins N. et al. The short and long term effects of exercise training in non-cystic fibrosis bronchiectasis – a randomised controlled trial. Respir. Res. 2014; 15 (15): 44. DOI: 10.1186/1465-9921-15-44.

117

Zanini A., Aiello M., Adamo D. et al. Effects of pulmonary rehabilitation in patients with non-cystic fibrosis bronchiectasis: a retrospective analysis of clinical and functional predictors of efficacy. Respiration. 2015; 89 (6): 525–533. DOI: 10.1159/000380771.

118

Bradley J., Moran F., Greenstone M. Physical training for bronchiectasis. Cochrane Database Syst. Rev. 2002; (3): CD002166. DOI: 10.1002/14651858.CD002166.

119

Lee A.L., Hill C.J., McDonald C.F. et al. Pulmonary rehabilitation in individuals with non-cystic fibrosis bronchiectasis: a systematic review. Arch. Phys. Med. Rehabil. 2017; 98 (4): 774–782.e1. DOI: 10.1016/j.apmr.2016.05.017.

120

Patterson J.E., Bradley J.M., Elborn J.S. Airway clearance in bronchiectasis: a randomized crossover trial of active cycle of breathing techniques (incorporating postural drainage and vibration) versus test of incremental respiratory endurance. Chron. Respir. Dis. 2004; 1 (3): 127–130. DOI: 10.1191/1479972304cd034oa.

121

Gokdemir Y., Karadag-Saygi E., Erdem E. et al. Comparison of conventional chest physiotherapy and high-frequency chest wall oscillation in primary ciliary dyskinesia. Pediatr. Pulmonol. 2014; 49 (6): 611–616. DOI: 10.1002/ppul.22861.

122

Mandal P., Sidhu M.K., Kope L. et al. A pilot study of pulmonary rehabilitation and chest physiotherapy versus chest physiotherapy alone in bronchiectasis. Respir. Med. 2012; 106 (12): 1647–1654. DOI: 10.1016/j.rmed.2012.08.004.

123

Newall C., Stockley R.A., Hill S.L. Exercise training and inspiratory muscle training in patients with bronchiectasis. Thorax. 2005; 60 (11): 943–948. DOI: 10.1136/thx.2004.028928.

124

Liaw M.Y., Wang Y.H., Tsai Y.C. et al. Inspiratory muscle training in bronchiectasis patients: a prospective randomized controlled study. Clin. Rehabil. 2011; 25 (6): 524–536. DOI: 10.1177/0269215510391682.

125

Aliberti S., Masefield S., Polverino E. et al. Research priorities in bronchiectasis: a consensus statement from the EMBARC Clinical Research Collaboration. Eur. Respir. J. 2016; 48 (3): 632–647. DOI: 10.1183/13993003.01888-2015.

126

Wilson C.B., Jones P.W., O’Leary C.J. et al. Validation of the St. George’s respiratory questionnaire in bronchiectasis. Am. J. Respir. Crit. Care Med. 1997; 156 (2, Pt 1): 536–541. DOI: 10.1164/ajrccm.156.2.9607083.

127

Quittner A.L., O‘Donnell A.E., Salathe M.A. et al. Quality of Life Questionnaire-Bronchiectasis: final psychometric analyses and determination of minimal important difference scores. Thorax. 2015; 70 (1): 12–20. DOI: 10.1136/thoraxjnl-2014-205918.

128

Martínez-García M.A., Soler-Cataluña J.J., Perpiñá-Tordera M. et al. Factors associated with lung function decline in adult patients with stable non-cystic fibrosis bronchiectasis. Chest. 2007; 132 (5): 1565–1572. DOI: 10.1378/chest.07-0490.

129

Chalmers J.D., Aliberti S., Blasi F. Management of bronchiectasis in adults. Eur. Respir. J. 2015; 45 (5): 1446–1462. DOI: 10.1183/09031936.00119114.

130

Goeminne P.C., Scheers H., Decraene A. et al. Risk factors for morbidity and death in non-cystic fibrosis bronchiectasis: a retrospective cross-sectional analysis of CT diagnosed bronchiectatic patients. Respir. Res. 2012; 16 (13): 21. DOI: 10.1186/1465-9921-13-21.

131

Hill A.T., Haworth C.S., Aliberti S. et al. Pulmonary exacerbation in adults with bronchiectasis: a consensus definition for clinical research. Eur. Respir. J. 2017; 49 (6): 1700051. DOI: 10.1183/13993003.00051-2017.

132

Spinou A., Siegert R.J., Guan W.J. et al. The development and validation of the bronchiectasis health questionnaire. Eur. Respir. J. 2017; 49 (5): 1601532. DOI: 10.1183/13993003.01532-2016.

The authors declare that there are no conflicts of interest present.