Semin Respir Crit Care Med 2021; 42(04): 616-622
DOI: 10.1055/s-0041-1730922
Review Article

Airway Clearance and Mucoactive Therapies

Gerard Muñoz Castro
1  Department of Pneumology, Dr. Josep Trueta University Hospital, Girona, Spain
2  Bronchiectasis Group, Girona Biomedical Research Institute, Girona, Spain
3  Department of Physical Therapy, EUSES & ENTI, University of Girona and University of Barcelona, Barcelona, Spain
Ana Balañá Corberó
4  Department of Pneumology, Hospital del Mar-Parc de Salut Mar, Barcelona, Spain
5  Myogenesis, Inflammation and Muscle Function—IMIM, Barcelona, Spain
6  Department of Physical Therapy, EUIFN Blanquerna URL Barcelona, Barcelona, Spain
› Author Affiliations


The respiratory system is constantly exposed to external pathogens but has different and effective defense systems. The pathophysiology of bronchiectasis affects the defense system considerably in that alterations occur in the airway that reduce its effectiveness in mucociliary clearance and the greater presence of mucins leads to the accumulation of more adherent and viscous mucus. One of the pillars of treatment of this disease should be improvement of mucociliary clearance and a decrease in the adherence and viscosity of the mucus. To this end, the mobilization of secretions must be increased through effective respiratory physiotherapy techniques, which can be manual and/or instrumental. The properties of mucus can be modified to improve its mobilization through the use of a mucoactive agent. Despite the increase in the number and quality of studies, the evidence for these treatments remains scarce, although their application is recommended in all guidelines.

Publication History

Publication Date:
14 July 2021 (online)

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