![]() Their aim is to reduce airway obstruction caused by secretions occupying the airway lumen and so prevent respiratory tract infections, re-expand the collapsed areas of the lung, thus improving gas exchanges and decreasing the inflammatory response ( 1– 4).Ī wide range of treatments, techniques and devices are present in the scientific literature for managing bronchial encumbrance in respiratory physiotherapy but their very multiplicity begs the question in daily clinical practice: “which of these treatments is it better to use to obtain the better result in my patient?.” Up to now, for all ACTs there is insufficient evidence to prove their efficacy and effectiveness in different clinical scenarios or to affirm the superiority of one technique over another ( 5– 8). The term airway clearance techniques (ACTs) refers to a variety of different strategies used to eliminate excess secretions. The management of bronchial secretions is one of the main problems encountered in a wide spectrum of medical conditions ranging from respiratory disorders (e.g., COPD, bronchiectasis, cystic fibrosis) to neuromuscular disorders (e.g., ALS) to patients undergoing either thoracic or abdominal surgery. Different principles combination is a new field of investigation that goes toward an increasing of clinical complexity that will facing us. Cough Assist, Vacuum Techniques, systems that modulate airflow have more and more scientific evidence. Alongside methods with a strong background behind as postural drainage, manual techniques or PEP systems, the current orientation is increasingly aimed at devices that can mobilize and / or remove secretions. The purpose of this review is illustrate to the reader the different ACTs currently available and the related evidence present in literature. The management of bronchial secretions is one of the main problems encountered in a wide spectrum of medical conditions ranging from respiratory disorders, neuromuscular disorders and patients undergoing either thoracic or abdominal surgery. Pulmonary Rehabilitation Department, Istituti Clinici Scientifici Maugeri, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS), Institute of Veruno, Novara, Italy.Stefano Belli *, Ilaria Prince, Gloria Savio, Elena Paracchini, Davide Cattaneo, Manuela Bianchi, Francesca Masocco, Maria Teresa Bellanti and Bruno Balbi ![]()
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