European Respiratory Society guidelines for the management of adult bronchiectasis,European Respiratory Journal

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European Respiratory Society guidelines for the management of adult bronchiectasis
European Respiratory Journal ( IF 24.3 ) Pub Date : 2017-09-01 , DOI: 10.1183/13993003.00629-2017
Eva Polverino ₁ , Pieter C Goeminne _{2,

3} , Melissa J McDonnell _{4,

5,

6} , Stefano Aliberti ₇ , Sara E Marshall ₈ , Michael R Loebinger ₉ , Marlene Murris ₁₀ , Rafael Cantón ₁₁ , Antoni Torres ₁₂ , Katerina Dimakou ₁₃ , Anthony De Soyza _{14,

15} , Adam T Hill ₁₆ , Charles S Haworth ₁₇ , Montserrat Vendrell ₁₈ , Felix C Ringshausen ₁₉ , Dragan Subotic ₂₀ , Robert Wilson ₉ , Jordi Vilaró ₂₁ , Bjorn Stallberg ₂₂ , Tobias Welte ₁₉ , Gernot Rohde ₂₃ , Francesco Blasi ₇ , Stuart Elborn _{9,

24} , Marta Almagro ₂₅ , Alan Timothy ₂₅ , Thomas Ruddy ₂₅ , Thomy Tonia ₂₆ , David Rigau ₂₇ , James D Chalmers ₂₈

Affiliation

Servei de Pneumologia, Hospital Universitari Vall d'Hebron (HUVH), Institut de Recerca Vall d'Hebron (VHIR); Fundación Clínic, Hospital Clínic de Barcelona, Universitat de Barcelona, IDIBAPS, CIBERES Barcelona, Barcelona, Spain.
Dept of Respiratory Medicine, AZ Nikolaas, Sint-Niklaas, Belgium.
Dept of Respiratory Medicine, UZ Leuven, Leuven, Belgium.
Dept of Respiratory Medicine, Galway University Hospitals, Galway, Ireland.
Lung Biology Group, National University of Ireland, Galway, Ireland.
Institute of Cell and Molecular Biology, Newcastle University, Newcastle upon Tyne, UK.
Dept of Pathophysiology and Transplantation, Università degli Studi di Milano, Internal Medicine Department, Respiratory Unit and Adult Cystic Fibrosis Center Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico Milan, Milan, Italy.
Dept of Clinical Research, Immunology and Physiological Sciences, Wellcome, London, UK.
Host Defence Unit, Royal Brompton Hospital, Imperial College, London, UK.
Service de Pneumologie, Hôpital Larrey, CHU de Toulouse, Toulouse, France.
Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain.
Servei de Pneumologia, Hospital Clínic de Barcelona, Universitat de Barcelona, IDIBAPS, CIBERES Barcelona, Barcelona, Spain.
5th Pulmonary Dept, "Sotiria" Chest Hospital, Athens, Greece.
Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK.
Bronchiectasis Service, Freeman Hospital, Newcastle upon Tyne, UK.
Dept of Respiratory Medicine, Royal Infirmary and University of Edinburgh, Edinburgh, UK.
Cambridge Centre for Lung Infection, Papworth Hospital, Cambridge, UK.
Bronchiectasis Group, Girona Biomedical Research Institute (IDIBGI), Dr Trueta University Hospital, Girona, Spain.
Dept of Respiratory Medicine, Hannover Medical School, Member of the German Centre for Lung Research, Hannover, Germany.
Clinic for Thoracic Surgery - Clinical Centre of Serbia, University of Belgrade, Belgrade, Serbia.
FCS Blanquerna. Physical Activity and Health Group, Universitat Ramon Llull, Barcelona, Spain.
Dept of Public Health and Caring Science, Family Medicine and Preventive Medicine, Uppsala University, Uppsala, Sweden.
Dept of Respiratory Medicine, Maastricht University Medical Center, Maastricht, The Netherlands.
Queen's University Belfast, Belfast, UK.
European Lung Foundation (ELF)/EMBARC bronchiectasis patient advisory group.
Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
Iberoamerican Cochrane Center, Barcelona, Spain.
College of Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK

Bronchiectasis in adults is a chronic disorder associated with poor quality of life and frequent exacerbations in many patients. There have been no previous international guidelines. The European Respiratory Society guidelines for the management of adult bronchiectasis describe the appropriate investigation and treatment strategies determined by a systematic review of the literature. A multidisciplinary group representing respiratory medicine, microbiology, physiotherapy, thoracic surgery, primary care, methodology and patients considered the most relevant clinical questions (for both clinicians and patients) related to management of bronchiectasis. Nine key clinical questions were generated and a systematic review was conducted to identify published systematic reviews, randomised clinical trials and observational studies that answered these questions. We used the GRADE approach to define the quality of the evidence and the level of recommendations. The resulting guideline addresses the investigation of underlying causes of bronchiectasis, treatment of exacerbations, pathogen eradication, long term antibiotic treatment, anti-inflammatories, mucoactive drugs, bronchodilators, surgical treatment and respiratory physiotherapy. These recommendations can be used to benchmark quality of care for people with bronchiectasis across Europe and to improve outcomes. The publication of the first ERS guidelines for bronchiectasis http://ow.ly/wQSO30dU0nE

中文翻译：

欧洲呼吸学会成人支气管扩张管理指南

成人支气管扩张是一种慢性疾病，与许多患者的生活质量差和频繁恶化有关。以前没有国际准则。欧洲呼吸学会成人支气管扩张管理指南描述了通过文献系统回顾确定的适当调查和治疗策略。一个代表呼吸内科、微生物学、物理治疗、胸外科、初级保健、方法学和患者的多学科小组，考虑了与支气管扩张管理相关的最相关的临床问题（对临床医生和患者而言）。产生了九个关键临床问题，并进行了系统评价以确定已发表的系统评价，随机临床试验和观察性研究回答了这些问题。我们使用 GRADE 方法来定义证据质量和推荐水平。由此产生的指南涉及对支气管扩张的根本原因、恶化的治疗、病原体根除、长期抗生素治疗、抗炎药、粘液活性药物、支气管扩张剂、外科治疗和呼吸物理治疗的调查。这些建议可用于衡量欧洲支气管扩张患者的护理质量并改善结果。发布第一个 ERS 支气管扩张指南 http://ow.ly/wQSO30dU0nE 由此产生的指南涉及对支气管扩张的根本原因、恶化的治疗、病原体根除、长期抗生素治疗、抗炎药、粘液活性药物、支气管扩张剂、外科治疗和呼吸物理治疗的调查。这些建议可用于衡量欧洲支气管扩张患者的护理质量并改善结果。发布第一个 ERS 支气管扩张指南 http://ow.ly/wQSO30dU0nE 由此产生的指南涉及对支气管扩张的根本原因、恶化的治疗、病原体根除、长期抗生素治疗、抗炎药、粘液活性药物、支气管扩张剂、外科治疗和呼吸物理治疗的调查。这些建议可用于衡量欧洲支气管扩张患者的护理质量并改善结果。发布第一个 ERS 支气管扩张指南 http://ow.ly/wQSO30dU0nE

更新日期：2017-09-01

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