RT Journal Article
SR Electronic
T1 4-week daily airway clearance using oscillating positive-end expiratory pressure <em>versus</em> autogenic drainage in bronchiectasis patients: a randomised controlled trial
JF ERJ Open Research
JO erjor
FD European Respiratory Society
SP 00426-2021
DO 10.1183/23120541.00426-2021
VO 7
IS 4
A1 Livnat, Galit
A1 Yaari, Naama
A1 Stein, Nili
A1 Bentur, Lea
A1 Hanna, Moneera
A1 Harel, Maya
A1 Adir, Yochai
A1 Shteinberg, Michal
YR 2021
UL http://openres.ersjournals.com/content/7/4/00426-2021.abstract
AB Background Airway clearance is a fundamental component of bronchiectasis care. Lung clearance index (LCI) is a measurement of ventilation inhomogeneity. Its responsiveness to long-term airway clearance is unknown. We aimed to compare two methods of daily airway clearance over 4 weeks: autogenic drainage (AD) and oscillating positive airway pressure (oPEP), and to determine effects of airway clearance on LCI and clinical outcomes.Methods Adults with bronchiectasis naive to airway clearance were randomised to daily airway clearance with either AD or oPEP. Difference in LCI as primary outcome, spirometry, sputum volume and purulence, and quality of life were at randomisation and after 4 weeks of airway clearance.Results 51 patients (32 women and 19 men, mean age 66.2±12.8 years) were randomised and 49 completed the study (25 AD and 24 oPEP). The LCI and forced expiratory volume in 1 s did not change between visits between groups (difference between groups 0.02), nor between visits in either group. Sputum quantity decreased in 12 out of 24 (50%) of the oPEP group, and in six out of 25 (24%) of the AD group (p=0.044). The “treatment burden” worsened or was unchanged in 70% of participants randomised to AD and 55% randomised to oPEP (p=0.038).Conclusion Sputum quantity decreased in more participants randomised to oPEP group after 1 month of daily airway clearance, with a better treatment burden. The effects of 4 weeks of airway clearance on LCI were not significant in either treatment group.People with bronchiectasis were randomised to 4 weeks of two methods of daily airway clearance, autogenic drainage (AD) and oscillating PEP (oPEP). Sputum volume decreased in more people randomised to oPEP than AD. LCI did not change in either group. https://bit.ly/3gNj2bi