International consensus on airway clearance techniques for acute exacerbations of chronic obstructive pulmonary disease (AECOPD): a modified Delphi study.

<bold>Introduction:</bold> Airway clearance is an important component of treating patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD). A wide range of airway clearance techniques (ACTs) has been developed and used, but there are no recommendations to assist clinical decision for which ones to use. Our aim was to establish international consensus on selecting ACTs for different clinical scenarios in patients hospitalised with AECOPD. <bold>Methods:</bold> Modified Delphi of 2 rounds, with a panel of nominated experienced physiotherapists. The surveys used RedCap and had demographics, descriptive and consensus items with a 5-point Likert scale. Consensus was defined as 75% agreement. <bold>Results:</bold> 98/104 experts from 12 countries completed the 1st round and 65/98 experts the 2nd round of Delphi. 13/96 and 15/169 items reached consensus in the 1st and 2nd Delphi round, respectively; Figure 1. <fig><object-id>erj;64/suppl_68/PA1436/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig> <bold>Discussion:</bold> There was limited consensus about which ACTs clinicians should or should not use for AECOPD. Lack of consensus might reflect complexity in decision making, combining of techniques and other factors.