Short-Term Effect of Autogenic Drainage on Ventilation Inhomogeneity in Adult Subjects With Stable Non-Cystic Fibrosis Bronchiectasis
| Autor: | Nathalie Bauwens, Giuseppe Liistro, Anne-Sophie Aubriot, Gregory Reychler, William Poncin, Noémie Leeuwerck, Candice Nader, Sophie Gohy |
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| Rok vydání: | 2017 |
| Předmět: |
Pulmonary and Respiratory Medicine
Spirometry Adult Male Respiratory Therapy Vital Capacity Lung Clearance Index Critical Care and Intensive Care Medicine Pulmonary function testing 03 medical and health sciences Young Adult 0302 clinical medicine Drainage Postural medicine Humans Lung volumes 030212 general & internal medicine Prospective Studies Airway clearance technique Lung Aged Aged 80 and over Bronchiectasis medicine.diagnostic_test business.industry Sputum General Medicine Middle Aged medicine.disease Respiratory Function Tests Mucus Treatment Outcome 030228 respiratory system Anesthesia Breathing Female medicine.symptom business Pulmonary Ventilation |
| Zdroj: | Respiratory care. 62(5) |
| ISSN: | 1943-3654 |
| Popis: | BACKGROUND: Lung clearance index (LCI), a measure of ventilation inhomogeneity derived from a multiple-breath washout test, is a promising tool for assessing airway function in patients with non-cystic fibrosis bronchiectasis. However, it is unknown whether ventilation inhomogeneity could improve after successful elimination of excessive secretions within bronchiectasis. The objective of this work was to assess the short-term effects of lung secretion clearance using the autogenic drainage technique on standard lung function tests and LCI in subjects with non-cystic fibrosis bronchiectasis. METHODS: Nitrogen-based multiple-breath washout, spirometry, and body plethysmography tests were performed 30 min before autogenic drainage in adults with stable non-cystic fibrosis bronchiectasis. The autogenic drainage session was followed by a 5-min break, after which the tests were repeated in the same order. Sputum expectorated during autogenic drainage was quantified as dry weight and correlated with change between post- and pre-measurements (Δ). Paired t test or Wilcoxon signed-rank tests were used to compare pre- and post-autogenic drainage measurement outcomes. A P value of ≤.05 was considered as statistically significant. RESULTS: Twenty-four subjects were studied (18 females, median age [range]: 65 [21–81] y). Mean ± SD LCI significantly improved after autogenic drainage (10.88 ± 2.62 vs 10.53 ± 2.35, P = .042). However, only 20% of subjects with mucus hyperproduction during autogenic drainage had a ΔLCI that exceeded measurement variability. The percent of predicted slow vital capacity (SVC%) also slightly improved (88.7 ± 19.3% vs 90 ± 19.1%, P = .02). ΔLCI was inversely related to dry sputum weight (r = −.48, P = .02) and ΔSVC% (r = −.64, P = .001). ΔSVC% also correlated with dry sputum weight (r = 0.46, P = .02). CONCLUSIONS: In adults with non-cystic fibrosis bronchiectasis and mucus hypersecretion, autogenic drainage improved ventilation inhomogeneity. LCI change may be the result of the maximum recruited lung volume and the amount of cleared mucus secretion. (ClinicalTrials.gov registration NCT02411981.) |
| Databáze: | OpenAIRE |
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