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Plastic double-lumen endobronchial tube was used to maintain the airway in a patient with massive hemoptysis and nonresectable lung cancer. This tube is superior to the previously used Carlens tube, as it can be inserted in emergency situations and does not require surgical setting. In addition, the larger internal diameter of these tubes allows better airway clearance and passage of a flexible bronchoscope. The double-lumen tube may be considered as an alternative to selective main-stem intubation.

The global burden of children and young people (CYP) with bronchiectasis is being recognised increasingly. They experience a poor quality of life and recurrent respiratory exacerbations requiring additional treatment, including hospitalisation. However, there are no published data on patient-driven clinical needs and/or research priorities for paediatric bronchiectasis. Parent/patient-driven views are required to understand the clinical needs and research priorities to inform changes that benefit CYP with bronchiectasis and reduce their disease burden. The European Lung Foundation and the European Respiratory Society Task Force for paediatric bronchiectasis created an international roadmap of clinical and research priorities to guide, and as an extension of, the clinical practice guideline. This roadmap was based on two global web-based surveys. The first survey (10 languages) was completed by 225 respondents (parents of CYP with bronchiectasis and adults with bronchiectasis diagnosed in childhood) from 21 countries. The parent/patient survey encompassed both clinical and research priorities. The second survey, completed by 258 health practitioners from 54 countries, was limited to research priorities. The two highest clinical needs expressed by parents/patients were: having an action management plan for flare-ups/exacerbations and access to physiotherapists. The two highest health practitioners’ research priorities related to eradication of airway pathogens and optimal airway clearance techniques. Based on both surveys, the top 10 research priorities were derived, and unanimous consensus statements were formulated from these priorities. This document addresses parents'/patients' clinical and research priorities from both the parents'/patients' and clinicians' perspectives and will help guide research and clinical efforts to improve the lives of people with bronchiectasis., This document is an international roadmap on parents’/patients’ clinical and research priorities from both the parents’/patients’ and clinicians’ perspectives to help guide research and clinical efforts to improve the lives of people with bronchiectasis https://bit.ly/3xoonwi

Background Treadmill exercise and airway clearance with the Flutter® device have previously been shown to improve mucus clearance mechanisms in people with cystic fibrosis (CF) but have not been compared. It is therefore not known if treadmill exercise is an adequate form of airway clearance that could replace established airway clearance techniques, such as the Flutter®. The aim of this study was to evaluate respiratory flow, sputum properties and subjective responses of treadmill exercise and Flutter® therapy, compared to resting breathing (control). Methods Twenty-four adults with mild to severe CF lung disease (FEV1 28–86% predicted) completed a three-day randomised, controlled, cross-over study. Interventions consisted of 20 min of resting breathing (control), treadmill exercise at 60% of the participant’s peak oxygen consumption and Flutter® therapy. Respiratory flow was measured during the interventions. Sputum properties (solids content and mechanical impedance) and subjective responses (ease of expectoration and sense of chest congestion) were measured before, immediately after the interventions and after 20 min of recovery. Results Treadmill exercise and Flutter® resulted in similar significant increases in peak expiratory flow, but only Flutter® created an expiratory airflow bias (i.e. peak expiratory flow was at least 10% higher than peak inspiratory flow). Treadmill exercise and Flutter® therapy resulted in similar significant reductions in sputum mechanical impedance, but only treadmill exercise caused a transient increase in sputum hydration. Treadmill exercise improved ease of expectoration and Flutter® therapy improved subjective sense of chest congestion. Conclusions A single bout of treadmill exercise and Flutter® therapy were equally effective in augmenting mucus clearance mechanisms in adults with CF. Only longer term studies, however, will determine if exercise alone is an adequate form of airway clearance therapy that could replace other airway clearance techniques. Trial registration Australian and New Zealand Clinical Trials Registry, Registration number #ACTRN12609000168257, Retrospectively registered (Date submitted to registry 26/2/2009, First participant enrolled 27/2/2009, Date registered 6/4/2009). Electronic supplementary material The online version of this article (doi:10.1186/s12890-016-0360-8) contains supplementary material, which is available to authorized users.

Mucociliary airway clearance (MAC) as measured by tracheal mucus velocity (TMV) was evaluated in 14 patients with CF (18-43 years, mean = 25 yrs). A fiberoptic bronchoscope was passed transnasally into the trachea with topical Xylocaine anesthesia, and Teflon discs (0.68 mm dia, 0.13 mg) were blown onto the mucosa (Xylocaine has been shown previously not to alter TMV in unanesthetized sheep). The discs were filmed at ½-sec. intervals and TMV calculated from image size and film speed (J.Appl.Physiol. 43:495, 1973). TMV was slower in CF than in 20 normal volunteers (NV) (18-44 yrs, mean = 27 yrs): 2.6±3.3 mm/min (std. dev.) vs. 20.1±6.4 mm/min (p

Date of latest update: June 2005. Date of next update: Not given. Patient group: Adults (aged > 18 years) with chronic non-specific low back pain. Intended audience: Individuals or groups developing or updating practice guidelines, professional associations, health care providers, health promotion agencies, industry/employers, educationalists, policymakers, people with low back pain, and the general public. Additional versions: Nil to date. Expert working group: Eleven European professionals from nine countries, experts in the field of low back pain research from disciplines including anaesthesiology, psychology, physiology, rehabilitation medicine, physical medicine, physiotherapy, general practice, epidemiology, and orthopaedic surgery. Funded by: European Commission, Research Directorate-General, Department of Policy, Coordination and Strategy. Consultation with: Feedback was received from an additional 15 professionals representing a variety of disciplines from 12 European countries who were in the COST B13 Management Committee. COST is an intergovernmental framework for European Co-operation in the field of Scientific and Technical Research, allowing the co-ordination of nationally funded research on a European level. Approved by: Not documented specifically. Location: This publication can be accessed via the PEDro database, or directly at: http://www.backpaineurope.org/web/files/ WG2_Guidelines.pdf Chronic non-specific low back pain

WS9.1 Effectiveness of airway clearance techniques when patients choose their airway clearance technique M.P. McIlwaine1, J.L. Agnew2, N. Alarie3, L.C. Lands4, G.F. Davidson1, F. Ratjen5. 1BC Children’s Hospital, Cystic Fibrosis Clinic, Vancouver, Canada; 2The Hospital for Sick Children, Respiratory Medicine, Toronto, Canada; 3The Montreal Children’s Hospital, Cystic Fibrosis Clinic, Montreal, Canada; 4The Montreal Children’s Hospital, Division of Pediatric Respiratory Medicine, Montreal, Canada; 5The Hospital for Sick Children, Department of Respiratory Medicine, Toronto, Canada

185 An investigation into microbial contamination of physiotherapy airway clearance equipment in children with cystic fibrosis S. Rand1,2, L. Hill2, J. Soothill3, S.A. Prasad2. 1Portex Unit, UCL Institute of Child Health, London, United Kingdom; 2Cystic Fibrosis Unit, Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom; 3Microbiology Department, Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom